Association between central non-dipping pattern and platelets morphology in adults with type 1 diabetes without cardiovascular disease: a cross-sectional study
Abstract BackgroundPeople with type 1 diabetes mellitus (T1DM) have higher cardiovascular risk (CVR) compared to those from the general population. One of the markers of elevated CVR is a non-dipping pattern. Mean platelet volume (MPV) and platelet distribution width (PDW) are related to platelets' activation. Aortic systolic blood pressure (SBP Ao) has a better predictive value for cardiovascular disease than brachial systolic blood pressure (SBP Br). Hypertensives with non-dipping pattern have higher MPV than dippers. However, this relationship was never investigated among people with T1DM. This study aimed to investigate the association between central dipping pattern and platelets morphology in subjects with T1DM.MethodsWe measured SBPAo and SBPBr with a validated non-invasive brachial oscillometric device - Arteriograph 24 (TensioMed Ltd., Budapest, Hungary) - during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The non-dipping pattern was defined as a nocturnal SBP Ao fall of less than 10%. We collected medical history, anthropometrical features, and laboratory results. The group was divided based on the dipping pattern for dippers and non-dippers. ResultsFrom total 62 subjects (32 males) aged 30.1 (25.7-37) years with T1DM duration 15.0 (9.0-20) years, 36 were non-dippers based on SBP Ao. Non-dipper group had significantly higher MPV (10.4 [10-10.7] fl vs 10.9 [10.3-11.5] fl; p = 0.03) and PDW (12.3 [11.7-12.8] fl vs 13.95 [11.7-15.1] fl; p=0.02) than dipper group. The groups did not differ in classic risk factors. Multivariate logistic regression revealed that MPV (OR: 3.74; 95% CI =1.48-9.45; p = 0.005) and daily insulin intake (OR: 445.11; 95% CI = 4.25 - 46597.42; p = 0.01) were independently positively associated with non-dipping pattern based on SBP Ao. PDW was also independently positively related to central non-dipping pattern (OR: 1.91; 95% CI = 1.22 - 3.00; p = 0.005).ConclusionsT1DM subjects with central non-dipping pattern have higher values of MPV and PDW than dippers. MPV and PDW are independently positively associated with SBP Ao non-dipping pattern among people with T1DM.