Abstract
BackgroundThe present study evaluated the effects of glucose and blood pressure (BP) variability on oxidative stress in patients with type 2 diabetes mellitus (T2DM) and hypertension.MethodsA total of 60 inpatients with T2DM underwent continuous glucose monitoring (CGM) and ambulatory BP monitoring (ABPM). Oxidative stress was estimated using the diacron-reactive oxygen metabolites (d-ROMs) test. Glucose variability, mean glucose level, percentage coefficient of variation for glucose, mean amplitude of glycemic excursions (MAGE), and area under the postprandial plasma glucose curve were determined through CGM. BP variability was assessed by measuring average BP, standard deviation (SD) of systolic and diastolic BP, and coefficient of variation (CV) of systolic and diastolic BP during daytime and nighttime ABPM.ResultsParticipants had a mean age of 64.5 ± 13.3 years with the duration of the disease 13.9 ± 12.4 years and HbA1c of 8.5 ± 1.2%. Univariate analysis showed that MAGE, nighttime SDs of systolic and diastolic BP, and nighttime CV of systolic BP were significantly correlated with d-ROMs. Further, stepwise multiple regression analysis identified MAGE, nighttime SD and CV of diastolic BP, estimated glomerular filtration rate, and smoking as independent contributors to d-ROMs.ConclusionsOxidative stress was associated with daily glucose and nighttime diastolic BP variability in patients with T2DM and hypertension.Trial registration UMIN Clinical Trial Registry UMIN000035615, Registered January 22, 2019—retrospectively registered
Highlights
The present study evaluated the effects of glucose and blood pressure (BP) variability on oxidative stress in patients with type 2 diabetes mellitus (T2DM) and hypertension
The present study showed that nighttime but not daytime BP variability was associated with oxidative stress in patients with T2DM and hypertension
Baroreceptor reflex sensitivity has been associated with diabetic neuropathy [36], the present study found no relationship between BP variability, LF/ HF ratio, and coefficient of variation in the R–R intervals
Summary
The present study evaluated the effects of glucose and blood pressure (BP) variability on oxidative stress in patients with type 2 diabetes mellitus (T2DM) and hypertension. Hyperglycemic damage results from reactive oxygen species-induced activation of polyol, hexosamine, protein kinase C, and the advanced glycation end-product pathway [8]. Given that atherosclerosis can result from glucose variability-induced endothelial dysfunction through oxidative stress, the activation of oxidative stress could be a risk factor for diabetic complications [9]. Hypertension induces endothelial dysfunction through oxidative stress [10]. Angiotensin II has been reported to stimulate the production of reactive oxygen species, such as superoxide, through the activation of membranebound NADH or NADPH oxidase in hypertension [11, 12]. Nitric oxide inactivation by oxygen free radicals contributes to endothelial dysfunction in essential hypertension [13]
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