TY - JOUR
T1 - Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes
AU - Hayfron-Benjamin, Charles F.
AU - Quartey-Papafio, Theresa Ruby
AU - Amo-Nyarko, Tracy
AU - Antwi, Ewuradwoa A.
AU - Vormatu, Patience
AU - Agyei-Fedieley, Melody Kwatemah
AU - Obeng, Kwaku Amponsah
N1 - Funding Information: This work was funded by the Faculty Development Grant of the University of Ghana College of Health Science. Funding Information: We are very grateful to the study participants for taking part in the study. Patience Vormatu deserves special commendation for coordinating the recruitment and study procedures. We thank the research assistants (Abraham Ablor, Alexander Danquah, Maame Boatemaa Ansong, Michael Adjei, and Nii Adjetey Kwaw Wills) for assisting with interviews and anthropometric measurements. We also Edem Ahiabor for assisting with the retinal photography. We gratefully acknowledge the leadership and staff of the NDMRC for helping with various aspects of the study. We also acknowledge Elikem Jasper Butsey, Faustina Aba Amoah, Odelia Tamakloe, and Seth Agyemang, and the staff of the National Cardiothoracic center Laboratory and the KBTH Accident and Emergency Laboratory for running the biochemical tests. We are grateful to Dr. Charles Antwi-Boasiako, Dr. Yvonne Dei-Adomako, and Mr. Enoch Mensah for their support in biobank management and the high-quality storage of collected samples. Publisher Copyright: © 2023 The Authors
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background: In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP and its control with neural, renal, and retinal microvascular dysfunction. Methods: This was a cross-sectional study among 403 adults with T2D. Microvascular dysfunction was based on nephropathy (albumin-creatinine ratio ≥ 30 mg/g), neuropathy (vibration perception threshold ≥ 25 V and/or Diabetic Neuropathy Symptom score > 1), and retinopathy (based on retinal photography). Logistic regression was used to examine the associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction with adjustments for age, sex, diabetes duration, smoking pack years, HbA1c concentration, total cholesterol concentration, and BMI. Results: The mean age (± SD), proportion of females, and proportion of hypertensives were 56.35 (± 9.91) years, 75.7%, and 49.1%, respectively. In a fully adjusted model, hypertension was significantly associated with neuropathy [odds ratio 3.44, 95% confidence interval 1.96–6.04, P < 0.001] and nephropathy [2.05 (1.09–3.85), 0.026] but not for retinopathy [0.98 (0.42–2.31), 0.970]. Increasing Z-score systolic BP was significantly associated with nephropathy [1.43 (1.05–1.97), 0.025] but not for neuropathy [1.28 (0.98–1.67), 0.075] or retinopathy [1.27 (0.84–1.91), 0.261]. Increasing Z-score diastolic BP was significantly associated with nephropathy [1.81 (1.32 – 2.49), < 0.001] but not retinopathy [1.38 (0.92–2.05), 0.120] or neuropathy [0.86 (0.67–1.10), 0.230]. Conclusion: Our study shows varying strengths of associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction in different microcirculatory beds. Hypertension prevention and/or control may be valuable in the prevention/treatment of microvascular disease, especially nephropathy, and neuropathy.
AB - Background: In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP and its control with neural, renal, and retinal microvascular dysfunction. Methods: This was a cross-sectional study among 403 adults with T2D. Microvascular dysfunction was based on nephropathy (albumin-creatinine ratio ≥ 30 mg/g), neuropathy (vibration perception threshold ≥ 25 V and/or Diabetic Neuropathy Symptom score > 1), and retinopathy (based on retinal photography). Logistic regression was used to examine the associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction with adjustments for age, sex, diabetes duration, smoking pack years, HbA1c concentration, total cholesterol concentration, and BMI. Results: The mean age (± SD), proportion of females, and proportion of hypertensives were 56.35 (± 9.91) years, 75.7%, and 49.1%, respectively. In a fully adjusted model, hypertension was significantly associated with neuropathy [odds ratio 3.44, 95% confidence interval 1.96–6.04, P < 0.001] and nephropathy [2.05 (1.09–3.85), 0.026] but not for retinopathy [0.98 (0.42–2.31), 0.970]. Increasing Z-score systolic BP was significantly associated with nephropathy [1.43 (1.05–1.97), 0.025] but not for neuropathy [1.28 (0.98–1.67), 0.075] or retinopathy [1.27 (0.84–1.91), 0.261]. Increasing Z-score diastolic BP was significantly associated with nephropathy [1.81 (1.32 – 2.49), < 0.001] but not retinopathy [1.38 (0.92–2.05), 0.120] or neuropathy [0.86 (0.67–1.10), 0.230]. Conclusion: Our study shows varying strengths of associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction in different microcirculatory beds. Hypertension prevention and/or control may be valuable in the prevention/treatment of microvascular disease, especially nephropathy, and neuropathy.
KW - Blood pressure control
KW - Hypertension
KW - Microvascular complications
KW - Nephropathy
KW - Neuropathy
KW - Retinopathy
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85165030992&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.deman.2023.100160
DO - https://doi.org/10.1016/j.deman.2023.100160
M3 - Article
SN - 2666-9706
VL - 12
JO - Diabetes Epidemiology and Management
JF - Diabetes Epidemiology and Management
M1 - 100160
ER -