2型糖尿病患者における血糖指標と減塩がもたらす血圧低下との連関

Background : The majority of patients with type２diabetes mellitus（T２DM）have hypertension, leading to serious cardiovascular events, including acute myocardial infarction, heart failure and stroke. Therefore, blood pressure（BP）control is a critical issue in patients with T２DM. Although sodium restriction is known to reduce BP, it is unclear what factors are associated with sodium restriction-induced BP reduction in T２DM patients.
Subjects and Methods : A retrospective analysis was performed in hospitalized patients with T２DM（６６males and６１females, mean age :５８．１±１４．２years, mean HbA１c :９．５±２．０％）. They received diet therapy including sodium restriction as NaCl of５to８g/day during admission. The relationship between changes in systolic BP（SBP）during admission and clinical parameters at the time of admission was statistically analyzed.
Results : Mean SBP in the sodium-restricted patients was significantly reduced during admission（ from １３０．２±１６．１ to １２２．７±１３．９ mmHg, p＜０．０１）. Multiple regression analysis showed that serum creatinine levels and presence of hypertension were inversely associated with and that initial SBP value was positively associated with the change in SBP. On the other hand, no glycemic parameters, including fasting plasma glucose levels, HbA１c, M values calculated from daily blood glucose profile, duration of T２DM and duration of hospitalization, were associated with the change in SBP.
Conclusion : Sodium restriction-induced BP reduction in T２DM patients was associated with presence of hypertension, serum creatinine levels and initial SBP values. Sodium restriction is a useful treatment for T２DM patients regardless of their glycemic condition.