Prognostic significance of reverse dipping status on lower limb event in type 2 diabetic patients without peripheral arterial disease.
Ambulatory blood pressure monitoring
Lower limb amputation disease
Lower limb revascularization
Nocturnal dipping
Type 2 diabetes mellitus
Journal
Acta diabetologica
ISSN: 1432-5233
Titre abrégé: Acta Diabetol
Pays: Germany
ID NLM: 9200299
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
20
12
2021
accepted:
08
03
2022
pubmed:
26
3
2022
medline:
12
5
2022
entrez:
25
3
2022
Statut:
ppublish
Résumé
We assessed reverse dipping influence on the risk of lower limb events in type 2 diabetic patients without peripheral arterial disease. Patients with type 2 diabetes addressed for cardiovascular risk stratification in our university hospital from 2008 to 2012 underwent 24 h blood pressure monitoring. Patients with a prior history of limb revascularization or with a stenosis > 50% of the legs were excluded. Reverse dipping was defined as a greater night-versus day-time systolic blood pressure. The endpoint was the first occurrence of lower limb revascularization or limb amputation. Hazard ratios (HRs) and 95% confidence intervals were calculated using the Cox model. Two hundred and eighty-one patients were included. During a median follow-up of 9.4 [7.7-10.6] years, 20 lower limb events and 45 all-cause deaths were observed. Thirty-five patients were reverse dippers. The reverse dipping status was associated with lower limb events when considering all-cause death as a competitive risk, (HR 3.61 [1.16-11.2], P = 0.026). Reverse dipping, HbA1C and proteinuria were independently associated with lower limb outcome in a multivariable analysis (respectively HR 4.09 [1.29-12.9], P = 0.017, HR 1.30 [1.04-1.63], P = 0.022 and HR 1.06 [1.02-1.11], P = 0.001). Reverse dipping status is independently associated with worse limb outcome in type 2 diabetic patients.
Identifiants
pubmed: 35333978
doi: 10.1007/s00592-022-01879-y
pii: 10.1007/s00592-022-01879-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
843-850Informations de copyright
© 2022. Springer-Verlag Italia S.r.l., part of Springer Nature.
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