ABSTRACT
OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patien-ts (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.
Subject(s)
Blood Pressure/physiology , Circadian Rhythm/physiology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/physiopathology , Homocysteine/blood , Blood Glucose/metabolism , Cardiovascular Diseases/etiology , Case-Control Studies , Diabetes Mellitus, Type 2/complications , Female , Humans , Hyperhomocysteinemia/physiopathology , Male , Middle AgedABSTRACT
OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.
OBJETIVO: A taxa de redução da pressão arterial noturna (PAN) é menor em pacientes com diabetes melito tipo 2 (DM tipo 2). A hiper-homocisteinemia (HHC) perturba a estrutura e a função vascular, independentemente das causas subjacentes. O risco de desenvolvimento de doenças vasculares é maior em pacientes diabéticos com hiper-homocisteinemia do que em pacientes com níveis normais de homocisteína. O objetivo deste estudo foi investigar se há diferenças entre os níveis de homocisteína em pacientes com DM2 em condição dipper ou não dipper. SUJEITOS E MÉTODOS: Comparamos 50 pacientes (33 mulheres, 17 homens) com DM tipo 2 e 35 indivíduos saudáveis (18 mulheres, 17 homens), usados como grupo controle. A monitorização ambulatorial da pressão arterial (MAPA) e os níveis de hemocisteína foram medidos em todos os pacientes. RESULTADOS: Observamos que a porcentagem de não dipper foi de 72% em pacientes com DM tipo 2 e 57% no grupo controle. Em indivíduos diabéticos e controle, os níveis de homocisteína foram mais altos em indivíduos não dipper (respectivamente 13,4 ± 8,1 µmol/L e 11,8 ± 5 µmol/L) do que em indivíduos dipper (respectivamente, 11,8 ± 5,8 µmol/L e 10,1 ± 4,2 µmol/L), mas não houve diferença significativa entre os dois grupos (respectivamente, p = 0,545, p = 0,294). CONCLUSÃO: Em ambos os grupos, os níveis de homocisteína foram mais altos nos indivíduos não dipper do que nos indivíduos dipper, mas não houve diferença significativa entre os grupos. Altos níveis de homocisteína e a condição não dipper aumentam o risco cardiovascular. Portanto, a relação entre as alterações da pressão arterial noturna e os níveis de homocisteína deve ser investigada em um estudo mais amplo.