Exercise-induced albuminuria and circadian blood pressure abnormalities in type 2 diabetes

AIM To investigate the relationship between circadian variations in blood pressure(BP) and albuminuria at rest,and during exercise in non-hypertensive type 2 diabetes(T2D) patients.METHODS We conducted a cross-sectional study in well controlled T2D patients,non-hypertensive,without clinical proteinuria and normal creatinine clearance.In each participant,we recorded the BP using ambulatory bloodpressure monitoring(ABPM) for 24-h,and albuminuria at rest and after a standardized treadmill exercise.RESULTS We enrolled 27 type 2 patients with a median age of 52;and a mean duration of diabetes and HbA 1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively.Using a 24-h ABPM,we recorded a mean diurnal systolic blood pressure(SBP) of 128 ± 17 mmH g vs nocturnal of 123 ± 19 mmH g(P = 0.004),and mean diurnal diastolic blood pressure(DBP) of 83 ± 11 mmH g vs nocturnal 78 ± 14 mmH g(P = 0.002).There was a significant difference between albuminuria at rest [median = 23 mg,interquartile range(IQR) = 10-51] and after exercise(median = 35 mg,IQR = 23-80,P < 0.001).Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components(128 mmH g vs 110 mmH g,P = 0.03 for SBP;83 mmH g vs 66 mmH g,P = 0.04;106 vs 83,P = 0.02 for mean arterial pressure),as well as albuminuric patients at rest.Moreover,exercise induced albuminuria detect a less increase in nocturnal DBP(83 vs 86,P = 0.03) than resting albuminuria.CONCLUSION Exercise induced albuminuria is associated with an increase in nocturnal BP values in T2D patients.

AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill exercise.RESULTSWe enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting albuminuria.CONCLUSIONExercise induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.