Blood pressure parameters and its association with albuminuria in adolescents with type 1 diabetes mellitus and ABPM using Mobil-O-Graph.

Abstract

Abstract Introduction: This study aimed to evaluate the blood pressure (BP) status, including circadian profile, arterial stiffness parameters, and hemodynamic indicators, and its association with albuminuria in adolescents with type 1 diabetes mellitus. Methods: The study included 46 patients, with an average diabetes duration of 7.38 ± 3.48 years. Ambulatory blood pressure monitoring (ABPM) was conducted using an oscillometric device, the Mobil-O-Graph, which is a Pulse Wave Analysis Monitor. Results: Hypertension arterialis (HA) was diagnosed in 30% of the patients, prehypertension (preHA) in 53%, and normal blood pressure (N) in 17%. In most cases, elevated BP was attributed to isolated nocturnal diastolic BP increases (42% in preHA and 50% in HA). The preHA and HA groups exhibited significantly increased pulse wave velocity (PWV), a measure of arterial stiffness. Non-dipping status, characterized by the absence of nocturnal diastolic BP dipping, was only associated with urinary albumin excretion (UAE). UAE was positively correlated with 24-hour diastolic peripheral and central BP, diastolic load, heart rate, augmentation index (AIx@75), and nocturnal total vascular resistance (TVR). Conclusions: Hypertension is a common complication of type 1 diabetes mellitus in adolescents, primarily caused by elevated nocturnal diastolic BP. Arterial stiffness, as indicated by PWV, appears to be the main contributor to increased BP in adolescents with type 1 diabetes mellitus. Albuminuria is mainly associated with diastolic BP, particularly during the nocturnal period, including non-dipping status. The association of UAE with AIx@75 and nocturnal TVR suggests the presence of early-stage vascular disease in diabetic adolescents.