The frequency of arterial hypertension in young people with different types of diabetes mellitus

Abstract

Objective. Arterial hypertension (AH) and diabetes mellitus (DM) are frequent comorbid diseases, which are associated with a high level of disability and mortality. According to the literature hypertension occurs in 50–80% of patients with type 2 diabetes (DM2) (which constitute more than 90% of the population with type 2 diabetes), compared with 30% of patients with type 1 diabetes (DM1). Comparative studies on the frequency of AH in young patients with different types of DM in the Siberian region have not been conducted. The aim of the research work was to study the frequency of AH and associations of AH with clinical and laboratory parameters in various types of DM diagnosed before the age of 45 years.Design and methods. 174 patients with the onset of DM from 18 to 45 years old were included. They were under observation at the Research Institute of Internal and Preventive Medicine — Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences: in 20 patients DM1 was verified (group 1), in 80 — DM2 (group 2), 20 had HNF1A-MODY (Maturity-Onset Diabetes of the Young) (group 3), 36 had GCK-MODY (group 4), 18 had LADA (“latent autoimmune diabetes in adults”) (Group 5). All patients was done a clinical examination, determination of indicators of carbohydrate metabolism and basic biochemical parameters.Results. All groups were comparable in terms of gender, age, and duration of DM. AH of 1–2 degrees in group 1 was detected in 5 patients (25,0%), in 2 — in 20 people (25,0%), in 3 — in 5 (25,0%), in 4 — in 4 (11,1%), in 5 — in 4 (22,2%), significant differences were not identified. In different types of DM the development of AH is associated with various clinical and laboratory parameters. In DM1, the development of AH has a correlation with the age of the patient, with the level of low-density lipoprotein cholesterol; in DM2 — with the duration of diabetes, the patient’s age, body mass index, glucose level, lipid spectrum and diabetic complications; with HNF1A-MODY— with diabetic complications; with GCK-MODY — with the duration of diabetes, the age of the patient, with the level of total cholesterol, with the development of nephropathy; with LADA — with indicators of carbohydrate metabolism and triglycerides.Conclusions. It is necessary to screen for the presence of AH for any type of DM in young people. It is necessary to take into account the clinical and laboratory parameters associated with the AH depending on the type of DM.