The Correlation Analysis Of 24-hour Ambulatory Blood Pressure,osteoprotegerin And Intima-media Thickness

Objective:Through measuring and observing the 24-hour ambulatory blood pressure, Intima-media thickness( IMT) and serum osteoprotegerin( OPG) concentration in patients with diabetes,this paper analyzed 24-hour ambulatory blood pressure fluctuation characteristics, IMT and serum OPG concentrations of diabetic patients with diabetes and hypertension and explored the correlation of 24-hour ambulatory blood pressure, serum OPG concentration and IMT to provide guidance and control for early discovery of carotid atherosclerosis in type 2 diabetes mellitusMethods:This project was brought 60 patients with diabetes mellitus,and 32 normal control subjects of the endocrinology department of The Second Hospital of Hebei Medical University from April 2013 to January 2015 period.The type 2 diabetic patients were divided into three groups with or without hypertension: A: healthy control group of 32 people, including 17 men cases, female 15 cases,B: simple type 2 diabetes in 29 cases, including 15 males and 14 females,C: 31 cases of diabetes and hypertension group, including 14 males and 17 females; there was no significant difference in the three groups of patients in gender, age and body mass index.recorded all enrolled patients general condition, subjects worn non-invasive ambulatory blood pressure monitor cuff side instrument for 24-hour ambulatory blood pressure monitoring, observed d MSBP, d MDBP, n MSBP, n MDBP,d MAP,n MAP, And calculate diurnal mean arterial pressure difference percentage to understand circadian change of blood pressure,And determinated the carotid intima-media thickness(IMT) with high-resolution color Doppler ultrasound.Collected all the crowd fasting fresh plasma samples,and measured OPG levels by automatic detection ELISA. The data adopt SPESS13.0 statistical software to make statistical analysis.Results: 1 The group of age, gender, body mass index, showed no significant difference, the d MSBP, d MDBP, n MSBP, n MDBP, d MAP,n MAP in DM group and diabetes with hypertension group are higher than the healthy control group, the difference was statistically significant(P <0.05), diurnal mean arterial pressure difference percentage of DM group and diabetes with hypertension group were significantly lower than the healthy control group,the 24 hour ambulatory blood pressure showed " non dippers " characteristics,the difference statistically significant(P <0.05),diurnal mean arterial pressure value of diabetes with hypertension group, although slightly lower than the DM group, the difference was not statistically significant(P> 0.05).2 IMT of DM group and diabetes with hypertension group were higher than the healthy control group, the difference was statistically significant(P <0.05), and in the group of diabetic patients with hypertension carotid intima thickness(IMT) is greater than the DM group, the difference was statistically significant(P <0.05).3 rank sum test results for each group of OPG: serum OPG of DM group, diabetes with hypertension group was higher than the healthy control group, the difference was statistically significant(P <0.05), Serum OPG of DM group and diabetes with hypertension group, the difference was not statistically significant(P> 0.05).4 Daytime mean systolic pressure, diastolic pressure, mean the daynight average systolic blood pressure during the day, night average diastolic blood pressure, mean arterial pressure and nocturnal mean arterial pressure were positively correlated with IMT.5 The diurnal mean arterial pressure difference was negatively correlated with IMT.6 The value of serum OPG was positively correlated with IMT. 7 Serum osteoprotegerin value is negatively related to the diurnal meanarterial pressure difference(r =-0.537), day and night with the weakening or disappearance of mean arterial pressure, serum OPG will increase, the difference was statistically significant.Conclusions: 1 The change of 24 hours ambulatory blood pressure rhythm appeared In patients with simple type 2 diabetes,was "non-dippers". 24-hour ambulatory blood pressure in diabetic patients with hypertension were higher value, and there is significant rhythm abnormalities, was "non-dippers". 2 high blood pressure were risk factors for IMT thickening, the increasing of average daytime systolic blood pressure, diastolic blood pressure average daytime, nighttime mean systolic blood pressure, diastolic blood pressure at night on average, the average daytime and nighttime blood pressure and mean arterial pressure,the weaken or disappearing of circadian rhythms promoted IMT thickening. 3 The concentrations of serum OPG in patients with hypertension,diabetes without hypertension patients were increased, but were similar. 4 When IMT thickened,the serum OPG value increased, the diurnal mean arterial pressure difference decreased or disappeared when the serum OPG was elevated.