BACKGROUND Masked hypertension defined as having normal office blood pressure (BP) but hypertension detected by continuous BP monitoring has been observed in children and adolescents with type 1 diabetes (T1D). However, no study has evaluated whether masked hypertension is associated with glycemic variability (GV) in these patients. We hypothesized that masked hypertension might be associated with high GV in patients with T1D. METHODS This cross-sectional study performed continuous glucose monitoring (CGM) in parallel with ambulatory blood pressure monitoring (ABPM) in T1D patients aged 6-21 years. Patients who had known hypertension were excluded. CGM data from the same day as ABPM was calculated for GV including standard deviation (SD), coefficient of variation (CV) of glucose levels, and unstable glycemia which was defined as having a CV of glucose levels ≥ 36%. RESULTS Thirty-three patients had complete ABPM and CGM data. Mean (SD) age was 13.8 (3.8) years and mean (SD) duration of T1D was 5.4 (3.6) years. All patients had normal office BP, but ABPM showed masked hypertension in 9 patients (27%). In comparison with normotensive patients, patients with masked hypertension had longer duration of T1D (7.4 vs. 4.6 years, p = 0.049), higher insulin requirement (1.2 vs. 0.9 units/kg/day, p = 0.049), and higher SD of glucose (70.3 vs. 47.9 mg/dl, p = 0.038). Masked hypertension group had a greater number of patients (71% vs. 19%, p = 0.02) with unstable glycemia. Multivariate analysis revealed that unstable glycemia was associated with masked hypertension. CONCLUSIONS The presence of unstable glycemia in children and adolescents with T1D is associated with masked hypertension. Graphical abstract.

中文翻译：

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隐匿性高血压及其与 1 型糖尿病儿童和青少年血糖变异性指标的关联。

背景隐匿性高血压定义为诊室血压 (BP) 正常，但在患有 1 型糖尿病 (T1D) 的儿童和青少年中观察到通过连续血压监测检测到的高血压。然而，没有研究评估隐匿性高血压是否与这些患者的血糖变异性 (GV) 相关。我们假设隐匿性高血压可能与 T1D 患者的高 GV 相关。方法这项横断面研究对 6-21 岁的 T1D 患者进行了连续血糖监测 (CGM) 和动态血压监测 (ABPM)。已知患有高血压的患者被排除在外。计算 ABPM 同一天的 CGM 数据用于 GV，包括标准偏差 (SD)、葡萄糖水平的变异系数 (CV)、和不稳定的血糖，其定义为血糖水平的 CV ≥ 36%。结果 33 名患者具有完整的 ABPM 和 CGM 数据。平均 (SD) 年龄为 13.8 (3.8) 岁，T1D 的平均 (SD) 持续时间为 5.4 (3.6) 年。所有患者的诊室血压均正常，但 9 名患者 (27%) ABPM 显示隐匿性高血压。与血压正常的患者相比，隐匿性高血压患者的 T1D 持续时间更长（7.4 年与 4.6 年，p = 0.049），胰岛素需求量更高（1.2 与 0.9 单位/公斤/天，p = 0.049），以及更高的 SD葡萄糖（70.3 与 47.9 毫克/分升，p = 0.038）。隐匿性高血压组的血糖不稳定患者数量较多（71% 对 19%，p = 0.02）。多变量分析显示，不稳定的血糖与隐匿性高血压有关。结论 患有 T1D 的儿童和青少年血糖不稳定与隐匿性高血压有关。图形概要。