Exercise-induced albuminuria vs circadian variations in blood pressure in type 1 diabetes

AIM To investigated the relationship between exercise-induced ambulatory blood pressure measurement (ABPM) abnormalities in type 1 diabetes mellitus (T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the Yaounde Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio (ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1DM patients and 20 matched controls. T1DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure (BP) and renal function according to the general reference population. Non-diabetic controls were adolescents of general population matched for sex, age and BMI. RESULTS Mean duration of diabetes was 4.2 +/- 2.8 years. The mean 24 h systolic blood pressure (SBP) and diastolic blood pressure (DBP) were respectively 116 +/- 9 mmHg in the diabetic group vs 111 +/- 8 mmHg in the nondiabetic (P = 0.06), and 69 +/- 7 mm Hg vs 66 +/- 5 mm Hg (P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls (SBP: 118 +/- 10 mmHg vs 114 +/- 10 mmHg, P = 0.11; DBP: 71 +/- 7 mmHg vs 68 +/- 6 mmHg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP (112 +/- 11 mmHg vs 106 +/- 7 mmHg, P = 0.06) and to the mean arterial pressure (MAP) (89 +/- 9 mmHg vs 81 +/- 6 mmHg, P = 0.06). ACR at rest was similar in both groups (5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise (10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria (116 +/- 10 mmHg vs 108 +/- 10 mmHg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1DM.