Christian S Hansen1, Jan S Jensen2, Martin Ridderstråle3, Dorte Vistisen4, Marit E Jørgensen4, Jesper Fleischer5. 1. Department of Clinical Epidemiology, Steno Diabetes Center A/S, Gentofte, Denmark. Electronic address: csvh@steno.dk. 2. Department of Cardiology, Gentofte Hospital, Gentofte, Denmark. 3. Steno Diabetes Center A/S, Gentofte, Denmark. 4. Department of Clinical Epidemiology, Steno Diabetes Center A/S, Gentofte, Denmark. 5. Medical Research Laboratories, Clinical Institute of Medicine, Aarhus University, Aarhus, Denmark.
Abstract
AIMS: Vitamin B12 deficiency could be associated with cardiovascular autonomic neuropathy (CAN) in diabetes patients. We aim to investigate the association between serum levels of vitamin B12 and CAN in type 2 diabetes patients. METHODS: 469 ambulatory type 2 diabetes patients (mean diabetes duration 10.0years (IQR 5.0;17.0), mean age 59.0years (SD 11.6), 63% men, mean B12 289.0pmol/l (IQR 217;390)) were screened for CAN using three cardiovascular reflex tests, five minute resting heart rate (5min RHR) and heart rate variability indices. RESULTS: Serum levels of vitamin B12 were significantly lower in patients treated with metformin and/or proton pump inhibitors (PPIs) compared with patients not treated (p<0.001). A 25pmol/l higher level of vitamin B12 was associated with an odds ratio of the CAN diagnosis of 0.94 (95% CI 0.88; 1.00, p=0.034), an increase in E/I-ratio of 0.21% (95% CI 0.01; 0.43, p=0.038), and a decrease in 5min RHR of 0.25 beats per minute (95% CI -0.47; -0.03, p=0.025). CONCLUSION: Vitamin B12 may be inversely associated with CAN in patients with type 2 diabetes. Confirmatory studies investigating a causal role of vitamin B12 for the development of diabetic CAN are warranted.
AIMS: Vitamin B12 deficiency could be associated with cardiovascular autonomic neuropathy (CAN) in diabetespatients. We aim to investigate the association between serum levels of vitamin B12 and CAN in type 2 diabetespatients. METHODS: 469 ambulatory type 2 diabetespatients (mean diabetes duration 10.0years (IQR 5.0;17.0), mean age 59.0years (SD 11.6), 63% men, mean B12 289.0pmol/l (IQR 217;390)) were screened for CAN using three cardiovascular reflex tests, five minute resting heart rate (5min RHR) and heart rate variability indices. RESULTS: Serum levels of vitamin B12 were significantly lower in patients treated with metformin and/or proton pump inhibitors (PPIs) compared with patients not treated (p<0.001). A 25pmol/l higher level of vitamin B12 was associated with an odds ratio of the CAN diagnosis of 0.94 (95% CI 0.88; 1.00, p=0.034), an increase in E/I-ratio of 0.21% (95% CI 0.01; 0.43, p=0.038), and a decrease in 5min RHR of 0.25 beats per minute (95% CI -0.47; -0.03, p=0.025). CONCLUSION: Vitamin B12 may be inversely associated with CAN in patients with type 2 diabetes. Confirmatory studies investigating a causal role of vitamin B12 for the development of diabetic CAN are warranted.
Authors: Christian S Hansen; Marit E Jørgensen; Jesper Fleischer; Hans Erik Bøtker; Peter Rossing Journal: J Am Heart Assoc Date: 2019-06-19 Impact factor: 5.501
Authors: S Sreenivasa Reddy; Y K Prabhakar; Ch Uday Kumar; P Yadagiri Reddy; G Bhanuprakash Reddy Journal: Mol Vis Date: 2020-04-24 Impact factor: 2.367