Prognostic significance of reverse dipping status on lower limb event in type 2 diabetic patients without peripheral arterial disease. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Acta Diabetologica Année : 2022

Prognostic significance of reverse dipping status on lower limb event in type 2 diabetic patients without peripheral arterial disease.

Résumé

Aims We assessed reverse dipping influence on the risk of lower limb events in type 2 diabetic patients without peripheral arterial disease. Methods Patients with type 2 diabetes addressed for cardiovascular risk stratification in our university hospital from 2008 to 2012 underwent 24 h blood pressure monitoring. Patients with a prior history of limb revascularization or with a stenosis > 50% of the legs were excluded. Reverse dipping was defined as a greater night-versus day-time systolic blood pressure. The endpoint was the first occurrence of lower limb revascularization or limb amputation. Hazard ratios (HRs) and 95% confidence intervals were calculated using the Cox model. Results Two hundred and eighty-one patients were included. During a median follow-up of 9.4 [7.7–10.6] years, 20 lower limb events and 45 all-cause deaths were observed. Thirty-five patients were reverse dippers. The reverse dipping status was associated with lower limb events when considering all-cause death as a competitive risk, (HR 3.61 [1.16–11.2], P = 0.026). Reverse dipping, HbA1C and proteinuria were independently associated with lower limb outcome in a multivariable analysis (respectively HR 4.09 [1.29–12.9], P = 0.017, HR 1.30 [1.04–1.63], P = 0.022 and HR 1.06 [1.02–1.11], P = 0.001). Conclusions Reverse dipping status is independently associated with worse limb outcome in type 2 diabetic patients.
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Dates et versions

hal-03990593 , version 1 (15-02-2023)

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Citer

Pascal Delsart, Madleen Lemaitre, Anne Vanbergue, Sandro Ninni, Christophe Bauters, et al.. Prognostic significance of reverse dipping status on lower limb event in type 2 diabetic patients without peripheral arterial disease.. Acta Diabetologica, 2022, Acta Diabetologica, 59, p. 843-850. ⟨10.1007/s00592-022-01879-y⟩. ⟨hal-03990593⟩
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