Pulse pressure and inflammatory markers in subjects with type 1 diabetes mellitus

ABSTRACT

Type 1 diabetes is associated with excessive cardiovascular risk and earlier age-related Increase in pulse pressure [PP]. Inflammation and PP are predictors of cardiovascular disease. However few data suggested that PP may stimulate inflammation. Therefore. the present study aimed to determine the levels of some inflammatory markers [tumour necrosis factor alpha. interleukln-6 and C-reactive protein] and to study the relation between PP and these markers in normotensive subjects with type I diabetes mellitus with and without microvascular complications. The present study included 50 normotensive subjects [<130/85 mmHg] with type I diabetes meliltus [T1DM], 24 of them with microvascular complications [mean age 39.6 +/- 5.4 years] and 26 of them without microvascular complications [mean age 29.7 +/- 6.9 years] 20 healthy subjects [mean age 33.3 +/- 8.5 years] were selected as a control group. Recorded data Included age, sex, duration of diabetes, body mass index [DMI]. waist-to-hip ratio [WHR], systolic blood pressure [SBP], diastolic blood pressure [DBP]. pulse pressure [PP]. mean arterial blood pressure [MAP], microvascular complications, lipid profile. HbAlc. estimated glucose disposal rate [eGDR] and serum concentration of tumour necrosis factor-alpha [TNT-alpha]. interleukin-6 [IL-6] and C-reactive protein [CRP]. Compared with control subjects, diabetic patients with and without microvascular complications had higher PP [47 +/- 3 and 41 +/- 4 vs 37 +/- 4. P<0.001 and P<0.01 respectively], CRP [6.04 +/- 0.6 and 4.11 +/- 0.64 vs 2.59 +/- 0.57, P<0.001. both], 1L6 [31.66 +/- 3.3 and 21.38 +/- 36.2 vs 11.5 +/- 2.81, P<0.001 both], and TNT-alpha [66.45 +/- 12.66 and 37.26 +/- 8.17 vs 32.05 +/- 6.3, P<0.001 and P<0.05 respectively]. PP CRP. IL-6 and TNF-alpha were elevated [P<0.001 all] in diabetic patients with versus those without microvascular complications. CRP. IL-6 and TNF-alpha levels were higher in diabetic patients with macroalbuminuria compared to those with microalbuminuria [P<0.05 and P=0.012 and P<0.001 respectively]. PP in diabetic patients showed significant correlation with micro and macrovascular complications [P<0.0001]. CRP. IL-6 and TNF-alpha in diabetic patients had significant correlation with PP [r=0.722, P<0.0001 and r=0.770, P<0.0001 and r=0.775. P<0.0001 respectively] and diabetic micro and macrovascular complications [P<0.0001]. In normotensive subjects with type I diabetes mellitus. Inflammatory markers and PP are increased and have significant relation with each other and with diabetic microvascular complications. So. lowering of both PP and Inflammation might be helpful to optimize therapeutic management of vascular disease in type diabetes