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. 2019 Aug 31;18(2):419-428.
doi: 10.1007/s40200-019-00435-w. eCollection 2019 Dec.

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

Pooja Bhati  1 , Rizwan Alam  2 , Jamal Ali Moiz  1 , M Ejaz Hussain  1
Affiliations

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

Pooja Bhati et al. J Diabetes Metab Disord. .

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: Autonomic dysfunction; Biomarkers; Diabetes; Interleukins; Vascular endothelium.

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Conflict of interest statement

Conflict of interestThe authors have no conflict of interest

Figures

Fig. 1
Fig. 1
Forest plots demonstrating regression coefficients (β) and corresponding 95% confidence intervals for significant associations between biomarkers and measures of cardiac autonomic function in type 2 diabetes mellitus patients. Associations which were independent of the influence of any co-variable are presented. IL-6: interleukin-6; IL-18: interleukin-18; hsCRP: high sensitivity C-reactive protein; TP: total power; LF: low frequency power; NO: nitric oxide; eNOS: nitric oxide synthase; HF: high frequency power; RMSSD: root mean square of successive differences between adjacent R-R intervals; pNN50: percentage of N-N intervals that vary by more than 50 ms; 30/15 ratio: ratio of 30th and 15th R-R interval during head-up tilt test
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