Exercise-induced albuminuria and circadian blood pressure abnormalities in type 2 diabetes

• Published in: World journal of nephrology Vol. 6; no. 4; pp. 209 - 216
• Main Authors: Tankeu, Aurel T, Kaze, François Folefack, Noubiap, Jean Jacques, Chelo, David, Dehayem, Mesmin Yefou, Sobngwi, Eugene
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 06.07.2017
• Subjects: Observational Study; Ambulatory measurement of blood pressure; Exercise; Albuminuria; Type 2 diabetes mellitus
• ISSN: 2220-6124; 2220-6124
• DOI: 10.5527/wjn.v6.i4.209

AIM To investigate the relationship between circadian variations in blood pressure(BP) and albuminuria at rest,and during exercise in non-hypertensive type 2 diabetes(T2D) patients.METHODS We conducted a cross-sectional study in well controlled T2D patients,non-hypertensive,without clinical proteinuria and normal creatinine clearance.In each participant,we recorded the BP using ambulatory bloodpressure monitoring(ABPM) for 24-h,and albuminuria at rest and after a standardized treadmill exercise.RESULTS We enrolled 27 type 2 patients with a median age of 52;and a mean duration of diabetes and HbA 1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively.Using a 24-h ABPM,we recorded a mean diurnal systolic blood pressure(SBP) of 128 ± 17 mmH g vs nocturnal of 123 ± 19 mmH g(P = 0.004),and mean diurnal diastolic blood pressure(DBP) of 83 ± 11 mmH g vs nocturnal 78 ± 14 mmH g(P = 0.002).There was a significant difference between albuminuria at rest [median = 23 mg,interquartile range(IQR) = 10-51] and after exercise(median = 35 mg,IQR = 23-80,P < 0.001).Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components(128 mmH g vs 110 mmH g,P = 0.03 for SBP;83 mmH g vs 66 mmH g,P = 0.04;106 vs 83,P = 0.02 for mean arterial pressure),as well as albuminuric patients at rest.Moreover,exercise induced albuminuria detect a less increase in nocturnal DBP(83 vs 86,P = 0.03) than resting albuminuria.CONCLUSION Exercise induced albuminuria is associated with an increase in nocturnal BP values in T2D patients.