Higher systolic blood pressure is specifically associated with better islet beta-cell function in T2DM patients with high glycemic level

被引：4

作者：

Xia, Zhang ^{[1
]}

Song, Lijuan ^{[2
]}

Fang, Dongdong ^{[2
]}

You, Wenjun ^{[2
]}

Li, Feng ^{[2
,3
]}

Zheng, Deqiang ^{[1
,4
]}

Li, Yuhao ^{[1
]}

Lin, Lu ^{[5
]}

Dou, Jingtao ^{[5
]}

Su, Xin ^{[1
]}

Zhai, Qi ^{[1
]}

Zuo, Yingting ^{[1
]}

Zhang, Yibo ^{[1
]}

Gaisano, Herbert Y. Y. ^{[6
,7
]}

Jiang, Jiajia ^{[2
,3
]}

He, Yan ^{[1
,4
]}

机构：

[1] Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, 10 Xitoutiao, Beijing 100069, Peoples R China

[2] Jining 1 Peoples Hosp, Dept Endocrinol, 6 Jiankang Rd, Jining 272000, Shandong, Peoples R China

[3] Jining 1 Peoples Hosp, Inst Chron Dis Management, Jining, Shandong, Peoples R China

[4] Beijing Municipal Key Lab Clin Epidemiol, Beijing, Peoples R China

[5] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Endocrinol, Beijing, Peoples R China

[6] Univ Toronto, Dept Medicat, Toronto, ON, Canada

[7] Univ Toronto, Dept Physiol, Toronto, ON, Canada

来源：

CARDIOVASCULAR DIABETOLOGY | 2022年 / 21卷 / 01期

基金：

中国国家自然科学基金;

关键词：

Type 2 diabetes mellitus; Beta-cell function; Blood pressure; Mediating effect; CARDIOVASCULAR-DISEASE; DIABETES-MELLITUS;

D O I：

10.1186/s12933-022-01723-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Patients with type 2 diabetes mellitus (T2DM) usually have higher blood viscosity attributed to high blood glucose that can decrease blood supply to the pancreas. A mild increase in blood pressure (BP) has been reported as a potential compensatory response that can maintain blood perfusion in the islet. However, how BP influences beta-cell function in T2DM subjects remains inconsistent. This study aimed to examine the relationship between BP and beta-cell function in patients with T2DM under different HbA1c levels. Methods: This is a cross-sectional study of 615 T2DM patients, whose clinical data were extracted from hospital medical records. Beta-cell function was assessed by insulin secretion-sensitivity index-2 (ISSI2). Multivariable linear regression analysis and restricted cubic splines (RCS) analysis were performed to identify the association between systolic BP (SBP) and ISSI2. Mediation analysis was performed to determine whether higher SBP could reduce blood glucose by enhancing beta-cell function. Results: After adjustment of potential confounders, in participants with HbA1c >= 10%, the SBP between 140 to150 mmHg had the highest log ISSI2 (b = 0.227, 95% CI 0.053-0.402), an association specific to participants with < 1 year duration of diabetes. RCS analyses demonstrated an inverted U-shaped association between SBP and ISSI2 with the SBP at 144 mmHg corresponding to the best beta-cell function. This higher SBP was "paradoxically " associated with lower 2 h postprandial blood glucose (PBG) when SBP < 150 mmHg that was almost exclusively mediated by ISSI2 (mediating effect = - 0.043, 95%CI - 0.067 to - 0.018; mediating effect percentage = 94.7%, P < 0.01). SBP was however not associated with improvement in ISSI2 or 2 h PBG in participants with HbA1c < 10%. Conclusions: In early stage of diabetes, a slightly elevated SBP (140-150 mmHg) was transiently associated with better beta-cell function in T2DM patients with HbA1c <= 10% but not in those with HbA1c < 10%.

引用

页数：10

共 34 条

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