| Is HOMA index a predictor of nocturnal nondipping in hypertensives with newly diagnosed type 2 diabetes mellitus? | |
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MedLine Citation:
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PMID: 17496462 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Baris Afsar; Siren Sezer; Rengin Elsurer; Fatma Nurhan Ozdemir |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Blood pressure monitoring Volume: 12 ISSN: 1359-5237 ISO Abbreviation: Blood Press Monit Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-05-14 Completed Date: 2007-08-02 Revised Date: 2008-04-14 |
Medline Journal Info:
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Nlm Unique ID: 9606438 Medline TA: Blood Press Monit Country: England |
Other Details:
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Languages: eng Pagination: 133-9 Citation Subset: IM |
Affiliation:
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Department of Nephrology, Baskent University Hospital, Ankara, Turkey. afsarbrs@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure* Blood Pressure Monitoring, Ambulatory Case-Control Studies Diabetes Mellitus, Type 2 / blood, diagnosis*, physiopathology Female Homeostasis* Humans Hypertension / blood*, complications*, physiopathology Insulin Resistance Male Middle Aged Predictive Value of Tests |
| Comments/Corrections | |
Comment In:
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Blood Press Monit. 2008 Feb;13(1):63; author reply 63-4
[PMID:
18199927
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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