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Subclinical inflammation and endothelial dysfunction are linked to cardiac autonomic neuropathy in type 2 diabetes

  • Pooja Bhati
  • Rizwan Alam
  • Jamal Ali Moiz
  • M. Ejaz HussainEmail author
Research article
  • 7 Downloads

Abstract

Purpose

The present study aimed to examine association between inflammatory and endothelial function biomarkers and indices of cardiac autonomic control in T2DM patients.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Vascular endothelium Biomarkers Diabetes Autonomic dysfunction Interleukins 

Abbreviations

CAN

Cardiac autonomic neuropathy

T2DM

Type 2 diabetes mellitus

IL-6

Interleukin-6

IL-18

Interleukin-18

hsCRP

high sensitivity C-reactive protein

NO

Nitric oxide

eNOS

Endothelial nitric oxide synthase

ET-1

Endothelin-1

CVD

Cardiovascular disease

HRV

Heart rate variability

HR

Heart rate

DBT

Deep breathing test

VM

Valsalva Maneuvre

HUT

Head-up tilt

BP

Blood Pressure

HGT

Hand grip test

30/15 ratio

ratio of largest and shortest R-R interval at 30th and 15th second of head-up tilt test

ECG

Electrocardiography

FFT

Fast Fourier transform

mean NN

average of N-N intervals

SDNN

Standard deviation of N-N intervals

RMSSD

Root mean square of successive differences between adjacent R-R intervals

pNN50

percentage of consecutive N-N intervals that vary by more than 50 ms

TP

Total power

LF

Low frequency power

HF

High frequency power

LF/HF ratio

Ratio of low and high frequency power

CV

Coefficient of variability

HbA1c

Glycosylated hemoglobin

WC

Waist circumference

CI

Confidence intervals

VIF

Variance inflation factor

T1DM

Type 1 diabetes mellitus

CARTs

Cardiovascular autonomic reflex tests

ANS

Autonomic nervous system

Notes

Acknowledgements

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

Supplementary material

40200_2019_435_MOESM1_ESM.docx (12 kb)
Supplementary material 1 (DOCX 11 kb)
40200_2019_435_MOESM2_ESM.docx (20 kb)
Supplementary material 2 (DOCX 20 kb)
40200_2019_435_MOESM3_ESM.docx (19 kb)
Supplementary material 3 (DOCX 19 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Diabetes Research Group, Centre for Physiotherapy and Rehabilitation SciencesJamia Millia Islamia (A Central University)New DelhiIndia
  2. 2.Deen Dayal Upadhyay Kaushal KendraJamia Millia Islamia (A Central University)New DelhiIndia

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