Early blood pressure alterations are associated with pro-inflammatory markers in type 1 diabetes mellitus

Abstract

The aim of this study was to evaluate the relationship between early blood pressure (BP) changes (detected using ambulatory BP monitoring; ABPM) with different markers of inflammation and endothelial dysfunction in patients with type 1 diabetes mellitus (T1DM). The study design was observational cross-sectional in 85 T1DM patients, clinically normotensive and with normo-albuminuria. We analyzed the relationships between ABPM-measured BP alterations over 24 h with the inflammatory cytokines (interleukin-6 (IL-6), tumor necrosis factor-α and vascular endothelial growth factor (VEGF)) and the markers of endothelial damage (vascular adhesion molecule, intercellular adhesion molecule and plasminogen activator inhibitor-1 (PAI)). Despite being recorded as normotensive, 27 (31.8%) subjects presented with an average of pathological BP. VEGF levels were significantly elevated in the patients with an altered mean diurnal values compared with normotensives (112.33 (72.87-213.53) pg ml vs 71.03 (37.71-107.92) pg ml; P=0.007). Further, VEGF levels correlated significantly with the parameters of diurnal BP and of 24 h values. IL-6 concentration was a risk factor in the patients with hypertension (OR=1.406; P=0.027). There were no modifications in the levels of markers of endothelial damage. Summarizing, there is an increase in pro-inflammatory cytokines, but not the endothelial adhesion molecules, in early stages of arterial hypertension in patients with T1DM.

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

“…These data show that ABPM could have specific utility in this group with double risk, obesity and GDM. In this group, we also observed higher levels of triglycerides, in agreement with some authors [33,34], and postulated that this atherogenic profile could be related to endothelial dysfunction causing subclinical BP alterations, as has been described in subjects with type 1 diabetes mellitus [35]. Pregnant women with obesity and GDM also had higher HbA1c levels and received insulin therapy more frequently than GDM women without obesity, similar to findings reported by other investigators [24,29], but in our cohort, there was no difference in the total dose of insulin used between the two groups.…”

IL-1β Implications in Type 1 Diabetes Mellitus Progression: Systematic Review and Meta-Analysis

“…The increased peripheral IL-1β levels in childhood indicate a potent role during the first years of the disease, which can contribute to the cytokine storm [ 32 ] associated with the first stage of T1DM. Primary prevention strategies targeting inflammatory-mediated comorbidity may prevent secondary complications in the future for these patients [ 33 , 34 , 35 ].…”

Adult kidney explants is a physiologic model for studying diabetic nephropathy

“…AK explants from Wistar rats were stimulated with a proinflammatory cocktail of cytokines (CKs), and AK explants from BB rats were cultured under basal conditions. appear due to the long cultivation period, our system allows for the maintenance of parameters related to inflammatory processes [30] under "ex vivo" conditions for a short period of 24-48 h. Due to the relationship established between inflammatory processes and cell death [31], our results provide solid support for the usefulness of this experimental technique since we managed not only to induce and reproduce an ex vivo model but also to modulate the response of AK explants from an animal model of DN.…”