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The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes
Mora Cty Hosp, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Ödeshög.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-9095-403X
Uppsala Univ, Sweden.
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2018 (English)In: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 27, no 4, p. 215-221Article in journal (Refereed) Published
Abstract [en]

Background: Endostatin, cleaved from collagen XVIII in the extracellular matrix, is a promising circulating biomarker for cardiovascular damage. It possesses anti-angiogenic and anti-fibrotic functions and has even been suggested to be involved in blood pressure regulation. Less is known if endostatin levels relate to circadian blood pressure patterns. In the present paper we studied the association between circulating levels of endostatin and nocturnal dipping in blood pressure.Methods: We used the CARDIPP-study, a cohort of middle aged, type 2 diabetics (n=593, 32% women), with data on both 24-hour and office blood pressure, serum-endostatin, cardiovascular risk factors, and incident major cardiovascular events. Nocturnal dipping was defined as a amp;gt;10% difference between day- and night-time blood pressures.Results: Two-hundred four participants (34%) were classified as non-dippers. The mean endostatin levels were significantly higher in non-dippers compared to dippers (meanstandard deviation: 62.6 +/- 1.8 mu g/l vs. 58.7 +/- 1.6 mu g/l, respectively, p=.007). Higher serum levels of endostatin were associated with a diminished decline in nocturnal blood pressure adjusted for age, sex, HbA1c, mean systolic day blood pressure, hypertension treatment, glomerular filtration rate, and prevalent cardiovascular disease (regression coefficient per SD increase of endostatin -0.01, 95% CI, -0.02-(-0.001), p=.03). Structural equation modelling analyses suggest that endostatin mediates 7% of the association between non-dipping and major cardiovascular events.Conclusion: We found an independent association between higher circulating levels of endostatin and a reduced difference between day- and night-time systolic blood pressure in patients with type 2 diabetes. Yet endostatin mediated only a small portion of the association between non-dipping and cardiovascular events arguing against a clinical utility of our findings.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2018. Vol. 27, no 4, p. 215-221
Keywords [en]
Ambulatory blood pressure; circadian blood pressure variation; endostatin; non-dipping; type 2 diabetes mellitus
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-149894DOI: 10.1080/08037051.2018.1444941ISI: 000437328100006PubMedID: 29488402OAI: oai:DiVA.org:liu-149894DiVA, id: diva2:1236398
Note

Funding Agencies|European Union [634869]; Swedish Research Council [2012-2215, 2015-03477]; Marianne and Marcus Wallenberg foundation [2012.0082]; Thureus Foundation; Landstinget Dalarna; Dalarna University; Swedish Heart-Lung Foundation [20150429, 20120169]; Lasarettslakare F. Olaisons foundation

Available from: 2018-08-02 Created: 2018-08-02 Last updated: 2019-05-01

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Östgren, Carl Johan

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Division of Community MedicineFaculty of Medicine and Health SciencesPrimary Health Care Center ÖdeshögDivision of Cardiovascular MedicineDepartment of Thoracic and Vascular SurgeryCenter for Medical Image Science and Visualization (CMIV)Department of Endocrinology
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