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Pulse Pressure is a Stronger Predictor Than Systolic Blood Pressure for Severe Eye Diseases in Diabetes Mellitus
http://hdl.handle.net/10191/00051715
http://hdl.handle.net/10191/00051715379a073f-37c0-449c-a806-0989908e6f80
名前 / ファイル | ライセンス | アクション |
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本文 (814.8 kB)
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要旨 (598.0 kB)
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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公開日 | 2020-07-08 | |||||
タイトル | ||||||
タイトル | Pulse Pressure is a Stronger Predictor Than Systolic Blood Pressure for Severe Eye Diseases in Diabetes Mellitus | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | blood pressure | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | diabetic mellitus | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | hemoglobin A1c | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pulse pressure | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pulse pressure | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | systolic blood pressure | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | vision-threatening treatment-required diabetic eye diseases | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_46ec | |||||
タイプ | thesis | |||||
その他のタイトル | ||||||
その他のタイトル | 糖尿病に起因する重症眼疾患の発症予測において、脈圧が収縮期血圧よりも優れていることが明らかとなった | |||||
著者 |
Yamamoto, Masahiko
× Yamamoto, Masahiko |
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著者別名 | ||||||
識別子 | 177879 | |||||
識別子Scheme | WEKO | |||||
姓名 | 山本, 正彦 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Evidence of the role of systolic blood pressure (SBP) in development of severe diabetic retinopathy is not strong, although the adverse effect of low diastolic blood pressure has been a partial explanation. We assessed the predictive ability of incident severe diabetic retinopathy between pulse pressure (PP) which considers both SBP and diastolic blood pressure, compared with SBP. Methods and Results: Eligible patients (12 242, 83% men) aged 19 to 72 years from a nationwide claims database were analyzed for a median observational 4.8-year period. Severe diabetic retinopathy was defined as vision-threatening treatment-required diabetic eye diseases. Multivariate Cox regression analysis revealed that hazard ratios (95% CI) of treatment-required diabetic eye diseases for 1 increment of standard deviation and the top tertile compared with the bottom tertile were 1.39 (1.21–1.60) and 1.72 (1.17–2.51), respectively, for PP and 1.22 (1.05–1.41) and 1.43 (0.97–2.11), respectively, for SBP adjusted for age, sex, body mass index, hemoglobin A1c, fasting plasma glucose, lipids, and smoking status. In a model with SBP and PP simultaneously as covariates, the hazard ratios of only PP (hazard ratios [95% CI], 1.57 [1.26–1.96]) but not SBP (0.85 [0.68–1.07]) were statistically significant. Delong test revealed a significant difference in the area under the receiver operating characteristic curve between PP and SBP (area under the receiver operating characteristic curve [95% CI], 0.58 [0.54–0.63] versus 0.54 [0.50–0.59]; P=0.03). The strongest predictor remained as hemoglobin A1c (area under the receiver operating characteristic curve [95% CI], 0.80 [0.77–0.84]). Conclusions: After excluding the significant impact of glycemic control, PP in comparison with SBP is a better predictor of severe diabetic retinopathy, suggesting a role of diastolic blood pressure and arterial stiffness in pathology. | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Journal of the American Heart Association. 2019, 8(8) | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | info:doi/10.1161/JAHA.118.010627 | |||||
権利 | ||||||
権利情報 | 【○!C】 2019 The Authors and JMDC, Inc. Published on behalf of the American Heart Association, Inc., by Wiley. | |||||
著者版フラグ | ||||||
値 | ETD | |||||
学位名 | ||||||
学位名 | 博士(医学) | |||||
学位授与機関 | ||||||
学位授与機関名 | 新潟大学 | |||||
学位授与年月日 | ||||||
学位授与年月日 | 2019-09-20 | |||||
学位授与番号 | ||||||
学位授与番号 | 13101甲第4634号 | |||||
学位記番号 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 新大院博(医)甲第894号 |