Previous studies have suggested a potential association of elevated blood pressure (BP) and the development of diabetic neuropathy for individuals with insulin-dependent diabetes mellitus. In this study, we examined an association between BP and vibratory thresholds (assessment modality of large sensory nerve fiber function) for 33 participants with non-insulin-dependent diabetes mellitus. There were 19 women and 14 men aged 58 +/- 7 (mean +/- SD) years, with diabetes duration of 7 +/- 6 years and a body mass index of 29 +/- 5 kg/m2. None of the individuals were taking any medications that lower BP and all were negative for the presence of microalbuminuria. Vibratory thresholds were determined at three visits using a two-alternative, forced-choice procedure. BP was assessed by 24-h ambulatory BP monitoring. As expected, vibratory thresholds were higher for men than for women (6.3 +/- 4 v 4.2 +/- 3 vibration units) but there was no statistical difference after controlling for height. In multivariate analyses with vibratory thresholds as the dependent variable, duration of diabetes (P < 0.01), age (P < .01) and systolic BP (SBP) (P < .01) explained approximately 70% of the overall variability of the gender-specific (ie, female) model. The variability was similar (ie, 70% to 73%) no matter which SBP measure was available for modeling. In terms of diastolic blood pressure (DBP) measures, only the percentage of abnormal readings (ie, > 90 mm Hg) for day DBP was found to be independently associated with vibratory thresholds for women. The association of BP and large sensory nerve fiber dysfunction for nonnephropathic diabetic women found in this cross-sectional study warrants further investigation.

译文

先前的研究表明,对于胰岛素依赖型糖尿病患者,血压升高 (BP) 与糖尿病神经病变的发展可能相关。在这项研究中,我们检查了33名非胰岛素依赖型糖尿病参与者的BP与振动阈值 (大感觉神经纤维功能的评估方式) 之间的关联。有19名女性和14名男性,年龄58/- 7 (平均/- SD) 岁,糖尿病持续时间为7/- 6年,体重指数为29/-5千克/m2。没有人服用任何降低血压的药物,并且所有药物均对微量白蛋白尿的存在呈阴性。使用两种选择的强制选择程序在三次访问时确定振动阈值。通过24小时动态血压监测评估血压。如预期的那样,男性的振动阈值高于女性 (6.3/- 4 v 4.2/- 3振动单位),但在控制身高后没有统计学差异。在以振动阈值为因变量的多变量分析中,糖尿病持续时间 (P <0.01),年龄 (P < .01) 和收缩压 (SBP) (P < .01) 解释了性别特异性 (即女性) 模型总体变异性的大约70%。无论哪种SBP测量可用于建模,变异性都是相似的 (即,70% 73%)。就舒张压 (DBP) 测量而言,仅发现日间DBP的异常读数 (即> 90毫米Hg) 的百分比与女性的振动阈值独立相关。在这项横断面研究中发现的非肾病性糖尿病妇女的BP与大感觉神经纤维功能障碍的关系值得进一步研究。

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