HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc07-0824v1 31/4/720    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dost, A. Search for Related Content PubMed PubMed Citation Articles by Dost, A. Social Bookmarking                What's this?

Arterial Hypertension Determined By Ambulatory Blood Pressure Profiles: Contribution To Microalbuminuria Risk In A Multicenter Investigation In 2105 Children And Adolescents With Diabetes Mellitus Type 1

Pediatrics of the Universities of Jena ¹,
Leipzig³,
Dresden⁵ and
Giessen⁷,
Pediatric Practice, Herford²,
Helios Children's Hospital, Erfurt⁴,
Epidemiology, University of Ulm⁶, Germany

Axel.Dost{at}med.uni-jena.de

ABSTRACT

Objective: Arterial hypertension is a key player in the development of diabetic complications. We used a nationwide database to study risk factors for abnormal 24-hour blood pressure (BP) regulation and microalbuminuria in children and adolescents with diabetes type 1.

Research design and methods: Ambulatory blood pressure monitoring (ABPM) was performed in 2105 children and adolescents from 195 pediatric diabetes centers in Germany and Austria. Individual LMS-SD scores were calculated for diurnal and nocturnal systolic (SBP), diastolic (DBP) and mean arterial BP (MAP) according to normalized values of a reference population of 949 healthy German children. The nocturnal BP reduction (dipping) was calculated for SBP as well as DBP.

Results: In diabetic children, particularly nocturnal BP was significantly elevated (SBP +0.51, DBP +0.58 and MAP +0.80 LMS-SDS) and dipping of SBP, DBP and MAP was significantly reduced (p<0.0001). Age, diabetes duration, gender, body mass index (BMI), HbA1c and insulin dose were related to altered blood pressure profiles; dipping, however, was only affected by age, female gender and HbA1c. The presence of microalbuminuria was associated with nocturnal diastolic BP (p<0.0001) and diastolic dipping (p<0.01).

Conclusions: Our observations revealed a clear link between the quality of metabolic control and altered BP regulation even in pediatric patients with short diabetes duration. Particularly, the nocturnal BP seems to contribute mainly to diabetic complications such as microalbuminuria.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?