title: Home-measured heart rate is associated with albuminuria in patients with type 2 diabetes mellitus: a post-hoc analysis of a cross-sectional multicenter study.
abstract: Epidemiological studies have shown that elevated heart rate (HR) is associated with an increased risk of diabetic nephropathy, as well as cardiovascular events and mortality, in patients with type 2 diabetes mellitus. Recently, the advantages of the self-measurement of blood pressure (BP) at home have been recognized. The aim of this study was to investigate the relationship between home-measured HR and albuminuria in patients with type 2 diabetes mellitus. We designed a cross-sectional multicenter analysis of 1245 patients with type 2 diabetes mellitus. We investigated the relationship between the logarithm of urinary albumin excretion (log UAE) and home-measured HR or other factors that may be related to nephropathy using univariate and multivariate analyses. Multivariate linear regression analysis indicated that age, duration of diabetes mellitus, morning HR (β=0.131, P<0.001), morning systolic BP (β=0.311, P<0.001), hemoglobin A1C, triglycerides, daily consumption of alcohol, use of angiotensin II receptor blockers and use of beta-blockers were independently associated with the log UAE. Multivariate logistic regression analysis indicated that the odds ratio (95% confidence interval) associated with 1 beat per min and 1 mm Hg increases in the morning HR and morning systolic BP for albuminuria were 1.024 ((1.008-1.040), P=0.004) and 1.039 ((1.029-1.048), P<0.001), respectively. In conclusion, home-measured HR was significantly associated with albuminuria independent of the known risk factors for nephropathy, including home-measured systolic BP, in patients with type 2 diabetes mellitus.
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ushigome
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
authors.affiliation: Laboratory of Experimental Immunology, WPI Immunology Frontier Research Center at Osaka University, Osaka, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Hamaguchi
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto First Red Cross Hospital, Kyoto, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Second Red Cross Hospital, Kyoto, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Atsuta
authors.affiliation: Department of Endocrinology and Metabolism, Osaka General Hospital of West Japan Railway Company, Osaka, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ohnishi
authors.affiliation: Department of Cardiology, Nishijin Hospital, Kyoto, Japan.
authors.forename: Sei
authors.initials: S
authors.lastname: Tsunoda
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Goji
authors.initials: G
authors.lastname: Hasegawa
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D015999:Multivariate Analysis; D012307:Risk Factors