Glomerular hyperfiltration is associated with blood pressure abnormalities in normotensive normoalbuminuric IDDM patients. 1997

M Pecis, and M J Azevedo, and J L Gross
Endocrine Unit, Hospital de ClĂ­nicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

OBJECTIVE To analyze the blood pressure patterns in normoalbuminuric IDDM patients with glomerular hyperfiltration. METHODS A controlled cross-sectional study of 38 normotensive normoalbuminuric (urinary albumin excretion rate < 20 micrograms/min) IDDM patients (18 hyperfiltering [glomerular filtration rate > 134 ml.min-1 1.73 m-2] and 20 normofiltering) and 20 normal individuals matched for age, sex, and BMI was performed. The 24-h ambulatory blood pressure was monitored using an auscultatory technique (Pressurometer IV, Del Mar Avionics), the glomerular filtration rate was measured by 51Cr-labeled EDTA method, extracellular volume by the distribution volume of 51Cr-labeled EDTA, and the 24-h urinary albumin excretion rate by radioimmunoassay. RESULTS Mean nocturnal diastolic blood pressure was higher in hyperfiltering IDDM patients (70.4 +/- mmHg), when compared with the control group (65.1 +/- 5.3 mmHg, P = 0.04). Diastolic blood pressure night:day ratio was higher in hyperfiltering IDDM patients (92.0 +/- 8.6%), when compared with normofiltering IDDM patients (85.9 +/- 4.8%) and control subjects (87.0 +/- 6.8%, P = 0.02). In IDDM patients, the glomerular filtration rate significantly correlated with the diastolic blood pressure night:day ratio (r = 0.5, P = 0.002), extracellular volume (r = 0.04, P = 0.002), and HbA1 (r = 0.3, P = 0.03). In stepwise multiple regression analysis, factors associated with glomerular filtration rate were diastolic blood pressure night:day ratio, extracellular volume, and HbA1 (adjusted r2 = 0.27, P = 0.003). CONCLUSIONS Glomerular hyperfiltration is associated with higher nocturnal diastolic blood pressure and with a blunted nocturnal decrease in diastolic blood pressure levels in normotensive and normoalbuminuric IDDM patients.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D003922 Diabetes Mellitus, Type 1 A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence. Diabetes Mellitus, Brittle,Diabetes Mellitus, Insulin-Dependent,Diabetes Mellitus, Juvenile-Onset,Diabetes Mellitus, Ketosis-Prone,Diabetes Mellitus, Sudden-Onset,Diabetes, Autoimmune,IDDM,Autoimmune Diabetes,Diabetes Mellitus, Insulin-Dependent, 1,Diabetes Mellitus, Type I,Insulin-Dependent Diabetes Mellitus 1,Juvenile-Onset Diabetes,Type 1 Diabetes,Type 1 Diabetes Mellitus,Brittle Diabetes Mellitus,Diabetes Mellitus, Insulin Dependent,Diabetes Mellitus, Juvenile Onset,Diabetes Mellitus, Ketosis Prone,Diabetes Mellitus, Sudden Onset,Diabetes, Juvenile-Onset,Diabetes, Type 1,Insulin Dependent Diabetes Mellitus 1,Insulin-Dependent Diabetes Mellitus,Juvenile Onset Diabetes,Juvenile-Onset Diabetes Mellitus,Ketosis-Prone Diabetes Mellitus,Sudden-Onset Diabetes Mellitus
D005260 Female Females
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006442 Glycated Hemoglobin Products of non-enzymatic reactions between GLUCOSE and HEMOGLOBIN (occurring as a minor fraction of the hemoglobin of ERYTHROCYTES.) It generally refers to glycated HEMOGLOBIN A. Hemoglobin A1c (Hb A1c) is hemoglobin A with GLYCATION on a terminal VALINE of the beta chain. Glycated hemoglobin A is used as an index of the average blood sugar level over a lifetime of erythrocytes. Fructated Hemoglobins,Glycohemoglobin,Glycohemoglobin A,Glycohemoglobins,Glycosylated Hemoglobin A,Hb A1c,HbA1,Hemoglobin A(1),Hemoglobin A, Glycosylated,Glycated Hemoglobin A,Glycated Hemoglobin A1c,Glycated Hemoglobins,Glycosylated Hemoglobin A1c,Hb A1,Hb A1a+b,Hb A1a-1,Hb A1a-2,Hb A1b,Hemoglobin, Glycated A1a-2,Hemoglobin, Glycated A1b,Hemoglobin, Glycosylated,Hemoglobin, Glycosylated A1a-1,Hemoglobin, Glycosylated A1b,A1a-1 Hemoglobin, Glycosylated,A1a-2 Hemoglobin, Glycated,A1b Hemoglobin, Glycated,A1b Hemoglobin, Glycosylated,Glycated A1a-2 Hemoglobin,Glycated A1b Hemoglobin,Glycosylated A1a-1 Hemoglobin,Glycosylated A1b Hemoglobin,Glycosylated Hemoglobin,Hemoglobin A, Glycated,Hemoglobin A1c, Glycated,Hemoglobin A1c, Glycosylated,Hemoglobin, Glycated,Hemoglobin, Glycated A1a 2,Hemoglobin, Glycosylated A1a 1,Hemoglobins, Fructated,Hemoglobins, Glycated
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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