Factors Influencing The Blood Pressure Variability And Its Relationship With Microalbuminuria In Inpatients With Type2Diabetes Mellitus

Objective To investigate the factors influencing the blood pressure variability (BPV) of inpatients with type2diabetes mellitus (T2DM) and discuss the relationship between the BPV and the microalbuminuria in inpatients with T2DM.Methods We collected104cases of type2diabetes who were hospitalized in the Endocrine inpatient department of the1st People’s hospital of Yueyang during the period of May,2012to January,2013. All the sample patients were under24h Noninvasive ambulatory blood pressure monitoring, and the24hSBPCV,24hDBPCV, dSBPCV, dDBPCV, nSBPCV, nDBPCV were calculated. Within one week after the ambulatory blood pressure monitoring, sample blood were drawn to test the fasting blood-glucose, glycosylated hemoglobin, serum triglyceride, cholesterol total, high density lipoprotein cholesterol, low density lipoprotein cholesterol, usea nitrogen, creatinine, Liver function.24h urine of patients was preserved for two times to test the microalbuminuria. SPSS17.0statistical software was for statistical analysis.Results (1) The percentage of non-dippers blood pressure is87.5%in inpatients with type2diabetes in our study. There is no gender difference (p>0.05), there is also no difference on non-dipper blood pressure ratio of the normal group and the abnormal group of urinary albumin.(p>0.05).(2) In the inpatients with type2diabetes in our study, the female patients had higher systolic BP and pulse pressure for day-time, night time and the whole day than male. The females had significantly higher night systolic BP than male(p<0.05). There were no significant difference in24-h, day-time result of systolic, diastolic and night diastolic BP between male and female patients(p>0.05). The BP variable coefficient of female patients was higher than that of male patients except the night diastolic BP variable coefficient. The female patients had significantly higher24-h diastolic BP variable coefficient(p <0.01) and lower AMBP(p<0.05)than male patients.(3) In stepwise multiple regression analysis, age was the major factor which influenced the24hSBPCV、24hDBPCV、nSBPCV and nDBPCV (P=0.044, P=0.000, P=0.010, P=0.001). TC was the variable of primary importance for24hSBPCV、24hDBPCV、dSBPCV and dDBPCV (P=0.013, P=0.019, P=0.003, P=0.004). HbA1c was the variable of primary importance for dSBPCV、dDBPCV and AMBP(P=0.024, P=0.039, P=0.000).(4) The results of analysis of covariance show that the dSBPCV and nDBPCV of patients with microalbuminuria were higher than that with normoalbuminuric (P=0.011, P=0.022). Conclusion (1) The BPV was affected by age, TC and HbA1c closely.(2) The dSBPCV and nDBPCV of patients with microalbuminuria were higher than patients with normoalbuminuria in inpatients with T2DM.