Effect of glycaemic control on the diurnal blood pressure variation and endogenous secretory receptor for advanced glycation end product (esRAGE) levels in type 1 diabetes mellitus

The relationship between plasma endogenous secretory receptor for advanced glycation end product (esRAGE) level and diurnal variation of blood pressure in type 1 diabetic patients based on their glycemic status has not yet been studied. So, the aim of the present study was to see if a correlation exists between plasma esRAGE levels and dipper status in type 1 diabetic patients based on their glycaemic status. Type 1 diabetic patients were divided as good and poor glycaemic controlled groups based on their HbA1c values. Blood glucose levels, insulin, insulin antibodies, homocysteine and esRAGE levels were determined. The hourly daytime and night-time blood pressure was monitored by using a non-invasive blood pressure (NIBP) apparatus. Of the 16 patients in the well-controlled group, most (14/16) were dippers (95 % confidence interval 1.5 to 20.7 vs. P = 0.006, Fisher’s exact test) when compared to those in the poorly controlled group (5/18). There was a significant correlation between plasma esRAGE levels and % decline in nocturnal blood pressure in both the good (r = 0.69, P = 0.003) and poorly (r = 0.79, P = 0.0002) controlled groups. Most of the poorly controlled patients showed abnormal circadian blood pressure pattern and low esRAGE level and hence were more prone to end organ damage.