Article Text

other Versions

PDF
Original article
Inflammatory markers are associated with cardiac autonomic dysfunction in recent-onset type 2 diabetes
  1. Christian Herder1,2,
  2. Imke Schamarek1,2,
  3. Bettina Nowotny1,2,
  4. Maren Carstensen-Kirberg1,2,
  5. Klaus Straßburger2,3,
  6. Peter Nowotny1,2,
  7. Julia M Kannenberg1,2,
  8. Alexander Strom1,2,
  9. Sonja Püttgen1,2,
  10. Karsten Müssig1,2,4,
  11. Julia Szendroedi1,2,4,
  12. Michael Roden1,2,4,
  13. Dan Ziegler1,2,4
  14. for the German Diabetes Study Group
    1. 1Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
    2. 2German Center for Diabetes Research (DZD), München-Neuherberg, Germany
    3. 3Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
    4. 4Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
    1. Correspondence to Dr Christian Herder MSc, Institute for Clinical Diabetology, German Diabetes Center, Auf'm Hennekamp 65, Düsseldorf 40225, Germany; christian.herder{at}ddz.uni-duesseldorf.de

    Abstract

    Objective Cardiovascular autonomic neuropathy is a common but underestimated diabetes-related disorder. Associations between cardiovascular autonomic dysfunction and subclinical inflammation, both risk factors of diabetic comorbidities and mortality, have been proposed in non-diabetic populations, while data for type 1 and type 2 diabetes are conflicting. Our aim was to investigate associations between inflammation-related biomarkers and cardiac autonomic dysfunction in patients with diabetes.

    Methods We characterised the associations between seven biomarkers of subclinical inflammation and cardiac autonomic dysfunction based on heart rate variability and cardiovascular autonomic reflex tests (CARTs) in 161 individuals with type 1 and 352 individuals with type 2 diabetes (time since diagnosis of diabetes <1 year). Analyses were adjusted for age, sex, anthropometric, metabolic and lifestyle factors, medication and cardiovascular comorbidities.

    Results In individuals with type 2 diabetes, higher serum interleukin (IL)-18 was associated with lower vagal activity (p≤0.015 for association with CARTs), whereas higher levels of total and high-molecular-weight adiponectin showed associations with very low frequency power, an indicator of reduced sympathetic activity (p≤0.014). Higher levels of soluble intercellular adhesion molecule-1 were associated with indicators of both lower vagal (p=0.025) and sympathetic (p=0.008) tone, soluble E-selectin with one indicator of lower vagal activity (p=0.047). Serum C-reactive protein and IL-6 were also related to cardiac autonomic dysfunction, but these associations were explained by confounding factors. No consistent associations were found in individuals with type 1 diabetes.

    Conclusions Biomarkers of inflammation were differentially associated with diminished cardiac autonomic dysfunction in recent-onset type 2 diabetes.

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.