Effects of Glucose and Blood Pressure Variability on Oxidative Stress in Type 2 Diabetes with Hypertension

Abstract

Aims: This study was performed to evaluate the effects of glucose variability (GV) and blood pressure variability (BV) on oxidative stress in type 2 diabetes patients with hypertension. Methods: Fifty-seven inpatients with type 2 diabetes (studied from May 2015 to august 2017) underwent continuous glucose monitoring (CGM) and ambulatory BP monitoring (ABPM) in a cross-sectional study. The plasma total oxidant capacity against N,N-diethylparaphenylendiamine was measured as a marker of oxidative stress using the d-ROMs test. The GV, mean glucose level (MGL), mean amplitude of glycemic excursions (MAGE), and area under the postprandial plasma glucose curve (AUCPP) were measured by CGM. The BV, mean blood pressure (MBP), max blood pressure (MaxBP), minimum blood pressure (MinBP), and standard deviation of blood pressure (BPSD) during the systole (S) and diastole (D) were measured by ABPM over daytime (day), nighttime (night), and 24-hour (24) periods. Results: The 57 participants were 65.3±12.9 years old, with a disease duration of 14.7±12.4 years and HbA1c of 8.5±1.2 %. In univariate analysis, MAGE (r=0.446,p<0.001), night DBPSD (r=0.323,p=0.014), and eGFR (r=0.287, p=0.030) were significantly correlated with the d-ROMs. In the stepwise multiple regression analysis, MAGE (β=0.344, t=3.075, p=0.003), night DBPSD (β=0.230, t=2.034, p=0.047), eGFR (β=-0.234, t=-2.137, p=0.037), and smoking (β=0.315, t=2.873, p=0.006) were identified as independent factors contributing to the d-ROMs (multiple R2 = 0.363). Conclusions: Daily glucose variability and nighttime systolic blood pressure variability are associated with oxidative stress in type 2 diabetes with hypertension. Disclosure M. Ohara: None. H. Nagaike: None. T. Yamamoto: None. T. Hayashi: None. T. Fukui: None. T. Hirano: Speaker's Bureau; Self; Novo Nordisk Inc., AstraZeneca.