Consiglio Nazionale delle Ricerche

Tipo di prodottoArticolo in rivista
TitoloImportance of glycemic control on the course of glomerular filtration rate in type 2 diabetes with hypertension and microalbuminuria under tight blood pressure control
Anno di pubblicazione2007
Autore/iThomaseth, K.; Pacini, G.; Morelli, P.; Tonolo, G.; Nosadini, R.
Affiliazioni autori1, 2: National Research Council, Institute of Biomedical Engineering, CNR, Corso Stati Uniti 4, 35127 Padova, Italy; 3: Bayer SpA, Milano, Italy; 4, 5: Endocrinology and Metabolic Diseases, University of Sassari, Sassari, Italy
Autori CNR e affiliazioni
AbstractBackground and aims To evaluate the role of glycemic control on the evolution of glomerular filtration rate (GFR) in type 2 diabetes (T2DM) with mild-moderate hypertension under tight blood pressure control, and to address the current controversy whether diabetic nephropathy worsens, independently of blood pressure, proportionally to HbA1c at any physiological level or only when HbA1c is above a 7.5-8% threshold. Methods and results T2DM (N = 127) during early stage diabetic nephropathy characterized by microalbuminuria were followed during a 2 year multicenter study. Individual GFR profiles were accurately obtained by 51Cr - EDTA bolus injections and analyzed with linear statistical mixed-effects models. GFR at baseline was significantly negatively correlated with age and plasma creatinine concentration (P <= 0.0001), and GFR declined, on average, by 4.0 ml/min 1.73 m2/year (P = 0.001). A significant correlation was found between individual GFR decline rate and average systolic (SBP) and diastolic (DBP) blood pressures (-0.254 (0.736) ml/min 1.73 m2/year per mmHg increase in SBP (DBP), P = 0.041 (0.014)) and % of glycated hemoglobin (HbA1c) (-1.78 ml/min 1.73 m2/year per % increase in HbA1c, P = 0.048). This implies a 44% increase/reduction in GFR decline rate for 1% HbA1c increase/reduction around 7.0% (i.e. 5.79 and 2.24 ml/min 1.73 m2/year at 8% and 6% HbA1c, respectively). Conclusions This study demonstrates that, despite tight blood pressure control, an accurate glycemic control till very low patterns of HbA1c (from 10-11% to 5-6%) is needed to delay the progression of GFR decay in Mediterranean T2DM in south Europe with microalbuminuria.
Lingua abstractinglese
Altro abstract-
Lingua altro abstract-
Pagine da632
Pagine a638
Pagine totali-
RivistaNMCD. Nutrition Metabolism and Cardiovascular Diseases (Testo stamp.)
Attiva dal 1991
Editore: Medikal Press. - Milano
Paese di pubblicazione: Italia
Lingua: inglese
ISSN: 0939-4753
Titolo chiave: NMCD. Nutrition Metabolism and Cardiovascular Diseases (Testo stamp.)
Titolo proprio: NMCD. Nutrition Metabolism and Cardiovascular Diseases. (Testo stamp.)
Titolo abbreviato: NMCD, Nutr. Metab. Cardiovasc. Dis. (Testo stamp.)
Titoli alternativi:
  • NMCD (Testo stamp.)
  • Nutrition Metabolism and Cardivascular Diseases (Testo stamp.)
Numero volume della rivista18
Fascicolo della rivista9
Verificato da refereeSì: Internazionale
Stato della pubblicazione-
Indicizzazione (in banche dati controllate)
  • ISI Web of Science (WOS) (Codice:000262038900009)
  • Scopus (Codice:2-s2.0-54049147443)
Parole chiaveType 2 diabetes, Glomerular filtration rate, Microalbuminuria, Hypertension, HbA1c
Link (URL, URI)
Titolo parallelo-
Data di accettazione-
Note/Altre informazioni-
Strutture CNR
  • IEIIT — Istituto di elettronica e di ingegneria dell'informazione e delle telecomunicazioni
  • ISIB — Istituto di ingegneria biomedica
Moduli/Attività/Sottoprogetti CNR
  • ME.P06.016.001 : Metodi e modelli matematici per la ricerca clinica sul metabolismo, il diabete e sue complicanze
Progetti Europei-

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