The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes
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 endostat...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2018-07-01
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| Series: | Blood Pressure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08037051.2018.1444941 |
| _version_ | 1827817888500678656 |
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| author | Jonas Wuopio Carl Johan Östgren Toste Länne Lars Lind Toralph Ruge Axel C. Carlsson Anders Larsson Fredrik H. Nyström Johan Ärnlöv |
| author_facet | Jonas Wuopio Carl Johan Östgren Toste Länne Lars Lind Toralph Ruge Axel C. Carlsson Anders Larsson Fredrik H. Nyström Johan Ärnlöv |
| author_sort | Jonas Wuopio |
| collection | DOAJ |
| description | 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 >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 (mean ± standard deviation: 62.6 ± 1.8 µg/l vs. 58.7 ± 1.6 µg/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. |
| first_indexed | 2024-03-12T00:39:40Z |
| format | Article |
| id | doaj.art-e4d0a0c5f9ef4f7fae16580a5e692064 |
| institution | Directory Open Access Journal |
| issn | 0803-7051 1651-1999 |
| language | English |
| last_indexed | 2024-03-12T00:39:40Z |
| publishDate | 2018-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Blood Pressure |
| spelling | doaj.art-e4d0a0c5f9ef4f7fae16580a5e6920642023-09-15T08:45:22ZengTaylor & Francis GroupBlood Pressure0803-70511651-19992018-07-0127421522110.1080/08037051.2018.14449411444941The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetesJonas Wuopio0Carl Johan Östgren1Toste Länne2Lars Lind3Toralph Ruge4Axel C. Carlsson5Anders Larsson6Fredrik H. Nyström7Johan Ärnlöv8Mora County HospitalLinköping UniversityLinköping UniversityUppsala UniversityKarolinska University HospitalKarolinska InstitutetUppsala UniversityLinköping UniversityKarolinska InstitutetBackground: 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 >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 (mean ± standard deviation: 62.6 ± 1.8 µg/l vs. 58.7 ± 1.6 µg/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.http://dx.doi.org/10.1080/08037051.2018.1444941ambulatory blood pressurecircadian blood pressure variationendostatinnon-dippingtype 2 diabetes mellitus |
| spellingShingle | Jonas Wuopio Carl Johan Östgren Toste Länne Lars Lind Toralph Ruge Axel C. Carlsson Anders Larsson Fredrik H. Nyström Johan Ärnlöv The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes Blood Pressure ambulatory blood pressure circadian blood pressure variation endostatin non-dipping type 2 diabetes mellitus |
| title | The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes |
| title_full | The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes |
| title_fullStr | The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes |
| title_full_unstemmed | The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes |
| title_short | The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes |
| title_sort | association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes |
| topic | ambulatory blood pressure circadian blood pressure variation endostatin non-dipping type 2 diabetes mellitus |
| url | http://dx.doi.org/10.1080/08037051.2018.1444941 |
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