Plasma Homocysteine and Fibrinogen Levels in Type 2 Diabetics with and without Nocturnal Blood Pressure Fall and Heart Rate Decrease

Abstract

Background The link between high levels of serum homocysteine and fibrinogen and cardiovascular morbidity appears to be much stronger in diabetics than in subjects with normal glucose tolerance. It has been suggested that patients with non-dipping pattern (non-dippers) are at greater risk of target organ damage. The aim of the present study was to evaluate the relationship between blunted diurnal blood pressure and heart rate profile and serum levels of homocysteine and fibrinogen in patients with type 2 diabetes mellitus.
Material and methods We studied 87 patients with type 2 diabetes mellitus. We evaluated the impact of retinopathy and nephropathy on diurnal blood pressure and heart rate profile. The patients were grouped according to the presence or lack of nocturnal blood pressure and heart rate decrease.
Results Microalbuminuria had no significant effect on diurnal blood pressure profile. Compared to patients without retinopathy, those with this complication had significantly smaller nocturnal blood pressure fall. Non-dipping blood pressure pattern status was linked to higher levels of serum homocysteine. Patients without nocturnal heart rate decrease had significantly greater fibrinogen levels.
Conclusions Presence of retinopathy is associated with significantly blunted nocturnal blood pressure fall in type 2 diabetes. Blunted diurnal blood pressure variation in type 2 diabetics is related to higher serum levels of homocysteine. In type 2 diabetics, non-dipping pattern of heart rate profile is linked to higher serum levels of fibrinogen.