Endocrine Abstracts

Introduction: The objective is to evaluate the relationship between precocious subclinical hypertension and inflammatory and endothelial dysfunction markers in normotensive and normoalbuminuric patients with type 1 diabetes.

Methods: We designed an observational transversal study of 85 patients, clinically normotensive and without microalbuminuria. Ambulatory blood pressure monitoring (abpm) was performed over 24 h and subclinical hypertension was considered if: i) mean systolic pressure (sbp) was >130 mmHg in the 24 h and daytime periods and >120 mmHg in the nighttime period and/or mean diastolic pressure (dbp) >80 or 70 mmHg in the same periods respectively and/or ii) more than 50% of the readings were higher than the defined previous criteria. Non dipper pattern was defined as nocturnal sbp or dbp <10% relative to the diurnal mean value. We analyzed the relationship between the blood pressure alterations detected by abpm and inflammatory cytokines (IL6, TNFα, and VEGF) and markers of endothelial damage (VCAM, ICAM, and PAI).

Results: Of the 85 patients included in the analysis, 55.3% (n: 47) were women with an average age of 27.9±6.1 years and a length of disease of 12.3±6.5 years. 31.8% presented pathological mean blood pressure parameters in some of the periods. VEGF levels were significantly higher in patients with diurnal blood pressure alterations relative to normotensive patients (112.33 (72.87–213.53) pg/ml vs 71.03 (37.71–107.92) pg/ml; P=0.007). In addition, VEGF levels showed a significant correlation with mean daytime and 24 h blood pressure parameters. IL6 levels showed as a risk factor in patients diagnosed with subclinical hypertension (OR: 1.406, P: 0.027). There were no modifications in the level of markers of endothelial damage.

Conclusions: An increase in proinflammatory cytokines, although not markers of endothelial damage, exists in precocious stages of hypertension in type 1 diabetic patients.