The levels of serum nitrite/nitrate and ambulatory blood pressure monitoring measures in childhood and adolescents with type 1 diabetes mellitus

ABSTRACT The Levels Of Serum Nitrite/Nitrate And Ambulatory Blood Pressure Monitoring Measures In Childhood And Adolescentcs With Type 1 Diabetes Melhtus To assess ambulatory blood pressure monitoring measures and nitrite/nitrate levels in normo- and microalbuminuric Type 1 diabetic sujects and healthy controls. Ambulatory blood pressure monitoring was undertaken in 40 Type 1 diabetic subjects (24 normo- and 16 microalbuminuric subjects) and 35 controls. Nitrite/nitrate levels was measured in all diabetic and 26 control subjects. Subjects were matched for age, bodymass index and diabetes duration. Microalbuminuria was diagnosed on the basis of a urinary albumin excretion rate between 20-200 ugr/min in two of the three 24-h urine collections. Microalbuminurics differed from the normoalbuminurics and controls in having significantly higher sistolic, diastolic and mean 24-h arterial pressure levels. Nigttime and 24-hour ambulatory heart rate was also significantly higher in microalbuminurics than the others. The loss of decline in nocturnal blood pressure (non-dipping) was observed for both sistolic and diastolic in microalbuminurics. Non-dipping in sistolic was also observed in normalbuminurics with increased glomerular filtration rate. Nitrite/nitrate levels were higher in microalbuminurics than normalbuminurics and controls but the difference was significant only for the latter. Nitrite/nitrate levels were positively correlated with all ambulatory blood pressure monitoring measures. Ambulatory blood pressure monitoring may accurately identify the changes in blood pressure in the early stage of diabetic nephropathy. Nitrite/nitrate seems to play an important role in the pathogenesis of renal hemodynamic changes early in the course of diabetes. The relationship between ambulatory blood pressure monitoring measures and NO levels might be a new era in prevention and/or slowing the progression of diabetic nephropathy. Key words: Type I diabetes melliius, Microalbuminuria, ambulatory blood pressure monitoring, nocturnal blood pressure, heart rate, renal hemodynamic changes rx