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The purpose of this study was to investigate the association between day-by-day variability in home blood pressure (HBP) on 14 consecutive days and macroalbuminuria in patients with type 2 diabetes. We compared the coefficient of variation (CV) of HBP in 858 Japanese patients with and without macroalbuminuria. Next, we analyzed the relationship between the logarithm of urinary albumin excretion (UAE) and the CV of HBP using linear regression analysis. Then, we evaluated the association between the CV of HBP and macroalbuminuria, defined as UAE X300 mg g À1 creatinine, using logistic regression analysis. The CVs of morning and evening systolic blood pressure (SBP) were significantly greater in patients with macroalbuminuria than in those without (8.08±3.35 vs. 7.19±2.25%, Po0.05 and 9.01±3.58 vs. 7.98±2.57%, Po0.05, respectively). Multivariate linear regression analyses indicated that the CVs of morning SBP (Po0.05) and diastolic blood pressure (DBP; Po0.05), and those of evening SBP (Po0.05) were the independent explanatory variables for the logarithm of UAE. Multivariate logistic regression analyses also demonstrated that the odds ratio for the CVs of morning SBP, morning DBP and evening SBP for macroalbuminuria were 1.35 (Po0.05), 1.29 (Po0.05) and 1.44 (Po0.05), respectively. We conclude that the CV of HBP is correlated with macroalbuminuria, independent of the known risk factors, in Japanese patients with type 2 diabetes.

Background and objectives: Patients with allergic disorders such as allergic rhinitis or asthma have been reported to be at increased risk for atherosclerosis. In this study, we evaluated the relationships between peripheral eosinophil count and degree of albumin excretion rate, which is a useful marker of cardiovascular mortality as well as diabetic nephropathy in patients with type 2 diabetes.Design, setting, participants, & measurements: We evaluated relationships of peripheral eosinophil count to degree of albumin excretion rate as well as to major cardiovascular risk factors, including age, BP, serum lipid concentration, and glycemic control (glycosylated hemoglobin); body mass index; current treatment for diabetes; smoking status; and presence of cardiovascular disease in 783 patients (416 men and 367 women) with type 2 diabetes.Results: Log(eosinophil count) was positively associated with systolic BP (r ‫؍‬ 0.124, P ‫؍‬ 0.0108), serum triglyceride concentration (r ‫؍‬ 0.108, P ‫؍‬ 0.0284), and log(albumin excretion rate) (r ‫؍‬ 0.301, P < 0.0001) in men; however, no association was found between log(eosinophil count) and log(albumin excretion rate) (r ‫؍‬ 0.085, P ‫؍‬ 0.1050) in women. Multivariate linear regression analysis demonstrated that log(eosinophil count) (␤ ‫؍‬ 0.260, P < 0.0001), duration of diabetes (␤ ‫؍‬ 0.203, P ‫؍‬ 0.0003), glycosylated hemoglobin (␤ ‫؍‬ 0.117, P ‫؍‬ 0.0238), systolic BP (␤ ‫؍‬ 0.205, P ‫؍‬ 0.0001), and serum triglyceride concentration (␤ ‫؍‬ 0.162, P ‫؍‬ 0.0038) were independent determinants of log(albumin excretion rate) in men.Conclusions: Allergic disorders may be associated with microalbuminuria in men with type 2 diabetes.

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