Introduction & Objective: Hypertension is common in type 1 diabetes (T1D). Renin-angiotensin aldosterone system (RAAS) and calcium-phosphate metabolism modulate blood pressure (BP). This study aimed to investigate the association of these factors with BP in adolescents with T1D.
Methods: Samples from 106 T1D (duration 7 years) and 106 healthy controls (HC) (similar age (10-17 years) and sex distribution) were analyzed for 25(OH)D, calcium, phosphate, PTH, FGF-23, klotho, plasma renin activity (PRA), aldosterone and urinary RAAS. Mean of two office blood pressure measurements, unpaired T-test, Chi-square, and linear regression (MLR) were used.
Results: Significant differences between TID and HC, were respectively: sBP (114.71 v 111.41), dBP (66.72 v 63.59), and BMI (22.16 v 20.91 kg/m2). PRA level was lower (0.21 v 1.8) and plasma aldosterone higher (444 v 65); higher urinary angiotensinogen (5.08 v 2.12) and urinary ACE2 activity (271.76 v 69.22) and lower urinary ACE activity (1.17 v 123.30); higher klotho (31.10 v 27.52) and PTH (36.42 v 24.11), lower 25(OH)D (56.94 v 88.42) and calcium (2.43 v 2.51). In T1D, unadjusted MLR; sBP was associated with BMI (p <0.005) and plasma phosphate (p <0.005); dBP with BMI (p <0.005), PTH (p = 0.026) and phosphate (p <0.005). Adjusted MLR; sBP was associated with BMI (< 0.005) and dBP with FGF 23 (0.047) and BMI (0.010).
Conclusion: Adolescents with T1D had higher BP and significant differences in RAAS, calcium and vitamin D hormones than HC, suggesting hormonal factors may modulate BP regulation pre-hypertension.
E. Mohammad: None. N. Lenherr-Taube: None. F.H. Mahmud: Research Support; Dexcom, Inc. R. Moineddin: None. E.B. Sochett: None.
