Relation of hypertension to diabetic nephropathy in patients with non-insulin-dependent diabetes mellitus--a pair-matched case-control study.

OBJECTIVE

To masess the role of hypertension and family history of hypertension in the development of nephropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM).

METHODS

A retrospective analysis was done on 2 groups of NIDDM patients, one group without proteinuria (urine protein < 300mg/24h, n = 106) and the other group with proteinuria (urine protein > or = 500mg/24h, n = 106). The 2 groups were matched by age (< or = +/- 3yrs), sex, ethnic and resident place. Some information of these subjects including demographic; history of disease, family history of diseases, lifestyle and behavior style variables was obtained by questionnaire; some variables were measured, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), quantity of protein in 24h urine. Then conditional logistic regression analysis was performed.

RESULTS

Some factors, including history of hypertension, longer duration of hypertension, higher levels of the past highest SBP and DBP, were independently associated with the occurrence risk of diabetic nephropathy (DN). Their corresponding odd ratios (OR) with 95% confidence intervals (CI) were 2.00(1.17 approximately 3.43), 1.25(1.08 approximately 1.46), 1.38(1.15 approximately 1.66), and 1.33(1.09 approximately 1.62) respectively, but family history of hypertension was not significantly associated with the development of DN. When/the above-mentioned relations were respectively adjusted by some possible confounding factors, they still existed.

CONCLUSIONS

History of hypertension, longer duration of hypertension, higher levels of the past highest SBP and DBP are independent risk factors for DN in Chinese NIDDM patients.