The features of 24-hour ambulatory blood pressure in patients with diabetes mellitus depending on endothelial dysfunction

N.O. Pertseva, D.I. Chub

Abstract


Background. Arterial hypertension in patients with diabetes mellitus (DM) plays a main role in the earlier formation of diabetic kidney disease (DKD). Endothelial dysfunction is considered to be a process based on the development of diabetic complications. It is important to study the markers, which gives the opportunity to identify DKD in early stage. Objective: to evaluate 24-h ambulatory blood pressure data in patients with DM and its correlation with estimated glomerular filtration rate and endothelial dysfunction. Materials and methods. The endothelial function was determined by the levels of transforming growth factor-beta 1 (TGF-b1) and vascular cell adhesion molecule 1 (VCAM-1). There were 124 patients with DM (66 with type 1 and 58 with type 2) under observation. Results. Levels of endothelial function (TGF-b1 and VCAM-1) indexes in patients with type 1 and type 2 DM depended on glomerular filtration rate. Between the indexes of endothelial function (TGF-b1, VCAM-1) and the 24-hour ambulatory blood pressure, there is strong and average correlation, therefore, parameters of 24-hour ambulatory blood pressure and presence of endothelial dysfunction can be considered as early signs of DKD progression in patients with DM. Conclusions. 24-hour ambulatory blood pressure in patients with DM on the early stages of diabetic nephropathy is characterized by significant circadian rhythm disorders. The insufficient night decline of blood pressure in patients with type 1 and type 2 DM characterizes the presence of diabetic nephropathy progression according to the indexes of 24-h ambulatory blood pressure.


Keywords


diabetic kidney disease; endothelial dysfunction markers; glomerular filtration rate; 24-h ambulatory blood pressure monitoring

References


Patel TP, Rawal K, Bagchi AK, et al. Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes. Heart Fail Rev. 2016 Jan;21(1):11-23. doi: 10.1007/s10741-015-9515-6.

Evseeva MV, Kalaeva VV. Clinical and pathogenetic aspects of cardiorenal relationships on background of type 2 diabetes. Sibirskoe medicinskoe obozrenie. 2016;(98):5-12. (in Russian).

Pasiechko NV, Pankiv IV, Vatsyk LM. Clinical value of microalbuminuria in patients with arterial hypertension and diabetes mellitus. Mìžnarodnij endokrinologìčnij žurnal. 2011;4(36):59-62. (in Ukrainian).

López-Hernández FJ, López-Novoa JM. Role of TGF-β in chronic kidney disease: an integration of tubular, glomerular and vascular effects. Cell Tissue Res. 2012 Jan;347(1):141-54. doi: 10.1007/s00441-011-1275-6.

Meng X, Nikolic-Paterson DJ, Lan HY. TGF-β: the master regulator of fibrosis. Nat Rev Nephrol. 2016 Jun;12(6):325-38. doi: 10.1038/nrneph.2016.48.

Gimbrone MA, García-Cardeña G. Endothelial Cell Dysfunction and the Pathobiology of Atherosclerosis. Circ Res. 2016 Feb 19;118(4):620-36. doi: 10.1161/CIRCRESAHA.115.306301.

Blankenberg S, Rupprecht HJ, Bickel C, et al. Circulating cell adhesion molecules and death in patients with coronary artery disease. Circulation. 2001;104(12):1336-1342. PMID: 11560847.

Triñanes J, Salido E, Fernández J, et al. Type 1 Diabetes Increases the Expression of Proinflammatory Cytokines and Adhesion Molecules in the Artery Wall of Candidate Patients for Kidney Transplantation. Diabetes Care. 2012 Feb;35(2):427-33. doi: 10.2337/dc11-1665.

Rebrova OYu. Statistical analysis of medical data. Application package STATISTICA. Moskow: Media-Sfera; 2006. 312 p. (in Russian)

Aksit E, Gursul E, Aydin F, Samsa M, Ozcelik F. Non-dipper hypertension is associated with slow coronary flow among hypertensives with normal coronary angiogram. Cardiovasc J Afr. 2017 Jan/Feb 23;28(1):14-18. doi: 10.5830/CVJA-2016-045.

MacIsaac RJ, Ekinci EI, Jerums G. Markers of and Risk Factors for the Development and Progression of Diabetic Kidney Disease. Am J Kidney Dis. 2014 Feb;63(2 Suppl 2):S39-62. doi: 10.1053/j.ajkd.2013.10.048.

Futrakul N, Chanakul A, Futrakul P, Deekajorndech T. Early stage of vascular disease and diabetic kidney disease: an underrecognized entity. Ren Fail. 2015;37(8):1243-6. doi: 10.3109/0886022X.2015.1073054.

Rossi GP, Seccia TM, Barton M, et al. Endothelial factors in the pathogenesis and treatment of chronic kidney disease Part II: Role in disease conditions a joint consensus statement from the European Society of Hypertension Working Group on Endothelin and Endothelial Factors and the Japanese Society of Hypertension. J Hypertens. 2018 Mar;36(3):462-471. doi: 10.1097/HJH.0000000000001600.




DOI: https://doi.org/10.22141/2224-0721.14.2.2018.130556

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