The Relationship Between Daytime, Nighttime and 24-Hour Heart Rate with Urinary Albumin and Protein Excretion in Patients with Newly Diagnosed Type 2 Diabetes

OBJECTIVE: Autonomic nervous system dysfunction (ASD) has been widely observed in patients with type 2 diabetes. 24-hour ambulatory blood pressure (ABP) and heart rate measurements have been found to associate with ASD in patient with Type 2 diabetes. Since albumin excretion is also related with ASD in type 2 diabetes; in the current study, the relationships between daytime, nighttime and 24- hour heart rates with 24 hour urinary albumin excretion (UAE) and 24-hour urinary protein excretion (UPE) were analyzed in patients with newly diagnosed type 2 diabetes. MATERIAL and METHODS: All patients underwent following procedures: history taking, physical examination, BP measurement, 12 lead electrocardiographic evaluations, routine urine analysis, biochemical analysis, 24-hour urine collection to measure UAE, UPE and creatinine clearance. 24-hour ABP and heart rate monitoring were performed for all patients. RESULTS: In total 80 patients with newly diagnosed type 2 diabetes were included. Stepwise linear regression revealed that logarithmically converted 24-hour UAE were independently related with 24- hour ambulatory SBP, (P:0.001) and heart rate (night) (P<0.0001). Stepwise linear regression revealed that logarithmically converted 24-hour UPE were independently related with age (P:0.032), with averaged fasting blood glucose (P:0.023), with 24-hour ambulatory SBP, (P:0.002) and with heart rate (night) (P:0.001). CONCLUSION: Nighttime heart rate, but not daytime and 24-hour heart rate was related with both 24-hour UAE and UPE in patients with Type 2 diabetes.