Higher systolic blood pressure is specifically associated with better islet beta-cell function in T2DM patients with high glycemic level

Cardiovascular Diabetology

Research

Dongdong Fang¹  Wenjun You¹  Lijuan Song¹  Feng Li²  Jiajia Jiang²  Lu Lin³  Jingtao Dou³  Zhang Xia⁴  Yibo Zhang⁴  Xin Su⁴  Yuhao Li⁴  Qi Zhai⁴  Yingting Zuo⁴  Deqiang Zheng⁵  Yan He⁵  Herbert Y. Gaisano⁶ 

[1] Department of Endocrinology, Jining No.1 People’s Hospital, 6 Jiankang Road, Rencheng District, 272000, Jining, Shandong, China;Department of Endocrinology, Jining No.1 People’s Hospital, 6 Jiankang Road, Rencheng District, 272000, Jining, Shandong, China;Institute for Chronic Disease Management, Jining No.1 People’s Hospital, Jining, Shandong, China;Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China;Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmen Wai, Fengtai District, 100069, Beijing, China;Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You’anmen Wai, Fengtai District, 100069, Beijing, China;Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China;Departments of Medication and Physiology, University of Toronto, Toronto, ON, Canada;

关键词: Type 2 diabetes mellitus;    Beta-cell function;    Blood pressure;    Mediating effect;   

DOI  :  10.1186/s12933-022-01723-1

 received in 2022-10-06, accepted in 2022-12-07,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPatients with type 2 diabetes mellitus (T2DM) usually have higher blood viscosity attributed to high blood glucose that can decrease blood supply to the pancreas. A mild increase in blood pressure (BP) has been reported as a potential compensatory response that can maintain blood perfusion in the islet. However, how BP influences beta-cell function in T2DM subjects remains inconsistent. This study aimed to examine the relationship between BP and beta-cell function in patients with T2DM under different HbA1c levels.MethodsThis is a cross-sectional study of 615 T2DM patients, whose clinical data were extracted from hospital medical records. Beta-cell function was assessed by insulin secretion-sensitivity index-2 (ISSI2). Multivariable linear regression analysis and restricted cubic splines (RCS) analysis were performed to identify the association between systolic BP (SBP) and ISSI2. Mediation analysis was performed to determine whether higher SBP could reduce blood glucose by enhancing beta-cell function.ResultsAfter adjustment of potential confounders, in participants with HbA1c ≥ 10%, the SBP between 140 to150 mmHg had the highest log ISSI2 (b = 0.227, 95% CI 0.053–0.402), an association specific to participants with < 1 year duration of diabetes. RCS analyses demonstrated an inverted U-shaped association between SBP and ISSI2 with the SBP at 144 mmHg corresponding to the best beta-cell function. This higher SBP was “paradoxically” associated with lower 2 h postprandial blood glucose (PBG) when SBP < 150 mmHg that was almost exclusively mediated by ISSI2 (mediating effect = − 0.043, 95%CI − 0.067 to − 0.018; mediating effect percentage = 94.7%, P < 0.01). SBP was however not associated with improvement in ISSI2 or 2 h PBG in participants with HbA1c < 10%.ConclusionsIn early stage of diabetes, a slightly elevated SBP (140–150 mmHg) was transiently associated with better beta-cell function in T2DM patients with HbA1c ≥ 10% but not in those with HbA1c < 10%.

【 授权许可】

CC BY   
© The Author(s) 2022

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