Hypertension in type 1 diabetic patients-the influence of body composition and body mass index: an observational study

Objective: To estimate the influence of body composition and body mass index on blood pressure in type 1 diabetic patients. Methods: This cross-sectional, observational study included 45 type 1 diabetic patients and 30 age and sex matched healthy volunteers. Blood pressure, anthropometric measurements, and body composition by dual X-ray absorptiometry (DXA) were done for all patients and controls. T-test, one way ANOVA and multiple regressions were used for statistical analyses. Results: Twenty diabetic patients (44.4%) had hypertension. Hypertensive diabetic patients had the highest total fat mass %, soft tissue fat mass %, abdomen fat % and fat/lean ratio followed by non hypertensives and the least was the controls (p=0.0001). Abdominal fat % was the only parameter significantly associated with mean arterial blood pressure (β-5.8, 95% CI: 3.7-8.0, p=0.0001) and systolic blood pressure (β-8.6, 95% CI: 5.4-11.9, p=0.0001) by stepwise multiple regression analysis in the diabetic patients. In the contrary, abdominal fat % (β-2.7, 95% CI: 0.9-4.5, p=0.006), duration of diabetes (β-2.5, 95% CI: 1.4-3.5, p=0.0001) and fat/ lean ratio (β-11.7, 95% CI: 1.5-21.9, p=0.03) were related to diastolic blood pressure. Conclusion: Diabetes is associated with an increase in body fat especially abdominal, which leads to an increase in insulin resistance and decrease in lean mass. In type 1 diabetic patients, blood pressure depends on body mass index SDS and fat mass. Abdominal fat is the only factor related to mean arterial blood pressure and systolic blood pressure.