Subclinical inflammation and endothelial dysfunction are linked to cardiac autonomic neuropathy in type 2 diabetes
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The present study aimed to examine association between inflammatory and endothelial function biomarkers and indices of cardiac autonomic control in T2DM patients.
50 T2DM patients were recruited for this study. For cardiac autonomic function, cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV) analysis was performed. Blood samples were collected for evaluating inflammatory and endothelial function biomarkers. Multivariable linear regression analysis adjusted for diabetes duration, glycemic control, waist circumference, hypertension, dyslipidemia, metformin, and statins was performed to examine the association between the biomarkers and cardiac autonomic function parameters.
Interleukin-6 was inversely related to total power (p = .009) and low frequency power (p = .04). Interleukin-18 and high sensitivity C-reactive protein inversely correlated with measures of cardiac vagal control (p < .05). Both nitric oxide and endothelial nitric oxide synthase were positively linked with cardiac vagal control indices (p < .05) whereas endothelin-1 did not show any independent association with cardiac autonomic function parameters.
Biomarkers of inflammation and endothelial function are associated with measures of cardiac vagal control and global HRV which suggest that there is some pathophysiological link between subclinical inflammation, endothelial dysfunction and cardiac autonomic dysfunction in T2DM.
KeywordsVascular endothelium Biomarkers Diabetes Autonomic dysfunction Interleukins
Cardiac autonomic neuropathy
Type 2 diabetes mellitus
high sensitivity C-reactive protein
Endothelial nitric oxide synthase
Heart rate variability
Deep breathing test
Hand grip test
- 30/15 ratio
ratio of largest and shortest R-R interval at 30th and 15th second of head-up tilt test
Fast Fourier transform
- mean NN
average of N-N intervals
Standard deviation of N-N intervals
Root mean square of successive differences between adjacent R-R intervals
percentage of consecutive N-N intervals that vary by more than 50 ms
Low frequency power
High frequency power
- LF/HF ratio
Ratio of low and high frequency power
Coefficient of variability
Variance inflation factor
Type 1 diabetes mellitus
Cardiovascular autonomic reflex tests
Autonomic nervous system
Authors would like to admit gratitude to University Grants Commission (UGC), India for providing fellowship to the author PB during this study. A sincere thank to Jamia Millia Islamia (A Central University) and UGC for providing adequate financial help during the study.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest
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