Impaired systolic blood dipping and nocturnal hypertension: an independent predictor of carotid intima-media thickness in type 1 diabetic patients

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dc.contributor.authorAtabek, Mehmet Emre
dc.contributor.authorAkyurek, Nesibe
dc.contributor.authorEklioglu, Beray Selver
dc.contributor.authorAlp, Hayrullah
dc.date.accessioned2024-02-23T14:12:45Z
dc.date.available2024-02-23T14:12:45Z
dc.date.issued2014
dc.departmentNEÜen_US
dc.description.abstractObjective: Type 1 diabetes in children predicts a broad range of later health problems including an increased risk of cardiovascular morbidity and mortality. This study aimed to evaluate whether nocturnal hypertension and impaired nocturnal dipping affect atherosclerosis in children and adolescents with type 1 diabetes and to investigate the relationship between atherogenic risk factors and carotid intima-media thickness (CIMT). Methods: One hundred fifty-nine type 1 diabetic patients and 100 healthy controls were included in the study. We investigated metabolic and anthropometric parameters such as body mass index (BMI), waist circumference, fasting glucose and insulin, serum lipids, 24 h ambulatory blood pressure monitoring (ABPM), and CIMT and compared these with those in control subjects (CS). Results: No difference was found between type 1 diabetic patients and CS in age, weight, waist/hip ratio, triglyceride, HDL-cholesterol level. However in children with type 1 diabetes, total cholesterol (p = 0.016), and LDL-cholesterol (p = 0.002) levels and CIMT (P < 0.001) were greater than those of controls. It was determined that 10% of type 1 diabetic patients had dyslipidemia. In 23.2% of type 1 diabetic patients, ABPM showed arterial hypertension. CIMT was significantly higher in the hypertensive group than in the nonhypertensive group (P = 0.003). Twenty-three (14.4%) diabetic patients had nocturnal hypertension. CIMT was significantly greater in the nocturnal hypertensive group (p = 0.023). Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) dipping was significantly different in diabetic patients (P < 0.001). CIMT was correlated positively with Hba1c (r = 0.220, p = 0.037), and negatively with SBP dipping (r = -0.362, p = 0.020) in the diabetic patients. In stepwise regression analysis, Hba1c and SBP dipping emerged as a significant predictor of CIMT (beta = 0.300, p = 0.044, beta = 0.398 p = 0.009) contributing to 15.58% of its variability. Conclusion: These results provide additional evidence for the presence of subclinical cardiovascular disease (CVD) and its relation to hypertension in type 1 diabetic patients. They also indicate a significant relation between nocturnal hypertension, SBP dipping and increased arterial stiffness. It is also important to note that our findings reveal significant relationships between HBA1c cardiovascular changes and underline the importance of glucose control to predict CVD. (C) 2014 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.jdiacomp.2013.09.007
dc.identifier.endpage55en_US
dc.identifier.issn1056-8727
dc.identifier.issn1873-460X
dc.identifier.issue1en_US
dc.identifier.pmid24157221en_US
dc.identifier.scopus2-s2.0-84891824320en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage51en_US
dc.identifier.urihttps://doi.org/10.1016/j.jdiacomp.2013.09.007
dc.identifier.urihttps://hdl.handle.net/20.500.12452/12163
dc.identifier.volume28en_US
dc.identifier.wosWOS:000329592100012en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofJournal Of Diabetes And Its Complicationsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectSubclinical Cardiovascular Diseaseen_US
dc.subjectType 1 Diabetesen_US
dc.subjectAmbulatory Blood Pressureen_US
dc.titleImpaired systolic blood dipping and nocturnal hypertension: an independent predictor of carotid intima-media thickness in type 1 diabetic patientsen_US
dc.typeArticleen_US

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