Hypertension in type 1 diabetic patients-the influence of body composition and body mass index: an observational study

Objective: To estimate the influence of body composition and body mass index on blood pressure in type 1 diabetic patients. Methods: This cross-sectional, observational study included 45 type 1 diabetic patients and 30 age and sex matched healthy volunteers. Blood pressure, anthropometric measurements, and body composition by dual X-ray absorptiometry (DXA) were done for all patients and controls. T-test, one way ANOVA and multiple regressions were used for statistical analyses. Results: Twenty diabetic patients (44.4%) had hypertension. Hypertensive diabetic patients had the highest total fat mass %, soft tissue fat mass %, abdomen fat % and fat/lean ratio followed by non hypertensives and the least was the controls (p=0.0001). Abdominal fat % was the only parameter significantly associated with mean arterial blood pressure (beta-5.8,95% CI: 3.7-8.0, p=0.0001) and systolic blood pressure (beta-8.6,95% CI: 5.4-11.9, p=0.0001) by stepwise multiple regression analysis in the diabetic patients. In the contrary, abdominal fat % ((3-2.7,95% CI: 0.9-4.5, p=0.006), duration of diabetes (beta-2.5,95% CI: 1.4-3.5, p=0.0001) and fat/lean ratio 1(beta-11.7, 95% CI: 1.5-21.9, p=0.03) were related to diastolic blood pressure. Conclusion: Diabetes is associated with an increase in body fat especially abdominal, which leads to an increase in insulin resistance and decrease in lean mass. In type 1 diabetic patients, blood pressure depends on body mass index SDS and fat mass. Abdominal fat is the only factor related to mean arterial blood pressure and systolic blood pressure. (Anadolu Kardiyol Derg 2012; 12: 60-4)