Case Control Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2017; 8(2): 74-79
Published online Feb 15, 2017. doi: 10.4239/wjd.v8.i2.74
Exercise-induced albuminuria vs circadian variations in blood pressure in type 1 diabetes
Isabelle Hota Tadida Meli, Aurel T Tankeu, Mesmin Y Dehayem, David Chelo, Jean Jacques N Noubiap, Eugene Sobngwi
Isabelle Hota Tadida Meli, Institut Supérieur des Sciences de la Santé, Université des Montagnes, 208 Bangangté, Cameroon
Aurel T Tankeu, Mesmin Y Dehayem, Eugene Sobngwi, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, 209 Yaoundé, Cameroon
Aurel T Tankeu, Mesmin Y Dehayem, Eugene Sobngwi, National Obesity Center, Yaoundé Central Hospital, 209 Yaoundé, Cameroon
David Chelo, Mother and Child Center of the Chantal Biya Foundation, 209 Yaoundé, Cameroon
Jean Jacques N Noubiap, Department of Medicine, Groote Schuur Hospital and University of Cape Town, 7295 Cape Town, South Africa
Author contributions: All the authors approved the final version of the manuscript.
Institutional review board statement: The study protocol was approved by the Ethical Committee of the Institut Supérieur des Sciences de la Santé, Université des Montagnes, Banganté, Cameroon, and was conducted in accordance with the guidelines of the Helsinki Declaration.
Informed consent statement: All participants and their parents or guardians (since many were adolescents) provided informed written concern prior to study enrollment.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: Data are available from the corresponding author upon request at sobngwieugene@yahoo.fr.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eugene Sobngwi, MD, MPhil, PhD, Associate Professor of Medicine, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, 209 Yaoundé, Cameroon. sobngwieugene@yahoo.fr
Telephone: +237-675088750
Received: July 10, 2016
Peer-review started: July 14, 2016
First decision: September 12, 2016
Revised: October 19, 2016
Accepted: November 27, 2016
Article in press: November 29, 2016
Published online: February 15, 2017
Processing time: 220 Days and 17.8 Hours
Abstract
AIM

To investigated the relationship between exercise-induced ambulatory blood pressure measurement (ABPM) abnormalities in type 1 diabetes mellitus (T1DM) adolescents.

METHODS

We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio (ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1DM patients and 20 matched controls. T1DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure (BP) and renal function according to the general reference population. Non-diabetic controls were adolescents of general population matched for sex, age and BMI.

RESULTS

Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure (SBP) and diastolic blood pressure (DBP) were respectively 116 ± 9 mmHg in the diabetic group vs 111 ± 8 mmHg in the non-diabetic (P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg (P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls (SBP: 118 ± 10 mmHg vs 114 ± 10 mmHg, P = 0.11; DBP: 71 ± 7 mmHg vs 68 ± 6 mmHg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP (112 ± 11 mmHg vs 106 ± 7 mmHg, P = 0.06) and to the mean arterial pressure (MAP) (89 ± 9 mmHg vs 81 ± 6 mmHg, P = 0.06). ACR at rest was similar in both groups (5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise (10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria (116 ± 10 mmHg vs 108 ± 10 mmHg, P = 0.09).

CONCLUSION

Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1DM.

Keywords: Albuminuria; Blood pressure; Ambulatory blood pressure measurement; Exercise; Type 1 diabetes

Core tip: Diabetic nephropathy (DN) is a major complication of type 1 diabetes mellitus (T1DM). Therefore, strategies for early detection are of critical importance. Ambulatory blood pressure measurement is useful for detection of precocious abnormalities in the occurrence of DN and exercise-induced albuminuria has been proposed as a potential predictor of DN. Our study therefore aimed to investigate the relationship between exercise-induced albuminuria and ambulatory blood pressure measurement abnormalities in T1DM Cameroonian adolescents. We found that T1DM patients had higher nocturnal and 24 h blood pressure figures than non-diabetics suggesting that exercise-induced albuminuria could be useful early detection of diabetes kidney injuries in T1DM.