Document Detail

Is HOMA index a predictor of nocturnal nondipping in hypertensives with newly diagnosed type 2 diabetes mellitus?
MedLine Citation:
PMID:  17496462     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Insulin resistance is involved in glucose intolerance, type 2 diabetes mellitus and hypertension. We aimed to analyze relationship between insulin resistance and nocturnal nondipping. METHODS: Patients underwent physical and biochemical evaluation, clinic and ambulatory blood pressure measurements. The homeostasis model assessment (HOMA) index was calculated. RESULTS: Ninety-six essential hypertensive patients, of whom 42 were dippers, with newly diagnosed type 2 diabetes mellitus were included. Nighttime average heart rate and mean arterial pressure of nondippers were higher than dippers (P<0.0001 and 0.001). Nondippers had higher fasting plasma glucose, serum insulin levels and HOMA indices than dipper patients (P=0.006, <0.0001 and <0.0001). Ten dippers and 36 nondippers were insulin resistant (P<0.0001). Clinic (r=+0.22, P=0.031), daytime average (r=+0.27, P=0.007), nighttime average (r=+0.33, P=0.001), 24-h average systolic (r=+0.25, P=0.015) and nighttime average diastolic blood pressures (r=+0.31, P=0.002) were positively correlated with homeostasis model assessment index. Nighttime mean arterial pressure and heart rates (daytime, nighttime, 24-h average) showed positive correlation with homeostasis model assessment index. In multivariate analysis, high homeostasis model assessment index was associated with increased nondipping risk (odds ratio: 1.85, confidence interval: 1.24-2.76, P=0.003). After adjustment of several factors, average nighttime systolic (P<0.0001), diastolic (P<0.0001) and 24-h diastolic blood pressure (P=0.029) and heart rate (P=0.001) measurements of insulin resistant patients were higher than nonresistant patients. CONCLUSIONS: Insulin resistance is related with diurnal blood pressure variation. The HOMA index may be a predictor of nocturnal nondipping in patients with essential hypertension and newly diagnosed type 2 diabetes mellitus.
Baris Afsar; Siren Sezer; Rengin Elsurer; Fatma Nurhan Ozdemir
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  12     ISSN:  1359-5237     ISO Abbreviation:  Blood Press Monit     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-14     Completed Date:  2007-08-02     Revised Date:  2008-04-14    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  133-9     Citation Subset:  IM    
Department of Nephrology, Baskent University Hospital, Ankara, Turkey.
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MeSH Terms
Blood Pressure*
Blood Pressure Monitoring, Ambulatory
Case-Control Studies
Diabetes Mellitus, Type 2 / blood,  diagnosis*,  physiopathology
Hypertension / blood*,  complications*,  physiopathology
Insulin Resistance
Middle Aged
Predictive Value of Tests
Comment In:
Blood Press Monit. 2008 Feb;13(1):63; author reply 63-4   [PMID:  18199927 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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