Association of serum adipocytokine levels with cardiac autonomic neuropathy in type 2 diabetic patients

Cardiovascular Diabetology

Original Investigation

Sang-Hee Jung¹  Bo-Yeon Kim²  Chul-Hee Kim²  Ji-Oh Mok²  Sung-Koo Kang²  Chan-Hee Jung² 

[1] Department of Obstetrics and Gynecology, Cha University School of Medicine, Bundang, Korea;Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, #108 Jung-Dong, Wonmi-Ku, 110-746, Bucheon, Kyunggi-Do, Korea;

关键词: Cardiac autonomic neuropathy;    heart rate variability;    leptin;    TNF- alpha;    adiponectin;    type 2 diabetes mellitus;   

DOI  :  10.1186/1475-2840-11-24

 received in 2011-12-19, accepted in 2012-03-13,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCardiac autonomic neuropathy (CAN) is a common complication of diabetes associated with poor prognosis. In addition, the autonomic imbalance is associated with cardiovascular disease (CVD) in diabetes. It is thought that adipocytokines contribute to the increased risk of vascular complications in patients with type 2 diabetes mellitus (T2DM). However, literature data on the association between CAN with adipocytokines such as leptin, tumor necrosis factor-alpha (TNF-alpha), adiponectin in subjects with T2DM is limited.Therefore, in the present study, we examined the relationship between fasting serum leptin, TNF- alpha and adiponectin and CAN in Korean T2DM patients.MethodsA total of 142 T2DM patients (94 males, 48 females) were recruited. CAN was assessed by the five tests according to the Ewing's protocol and the time and frequency domain of the heart rate variability (HRV) was evaluated. Serum TNF-alpha and adiponectin levels were measured using enzyme-linked immunosorbent assay and serum leptin levels were measured using radioimmunoassay.ResultsAlthough, the mean levels of leptin, TNF-alpha and adiponectin were not significantly different between the groups with and without CAN, the levels of leptin and adiponectin had a tendency to increase as the score of CAN increased (p = 0.05, p = 0.036). Serum leptin levels demonstrated a negative correlation with low frequency (LF) in the upright position (p = 0.037). Regarding TNF-alpha, a significant negative correlation was observed with SDNN and RMSSD in the upright position (p = 0.023, p = 0.019). Adiponectin levels were not related to any HRV parameters. Multivariate logistic regression analysis demonstrated that the odds of CAN increased with a longer duration of diabetes (1.25, [1.07-1.47]) and higher homeostatic model of assessment-insulin resistance (HOMA-IR) (5.47, [1.8-16.5]). The relative risks for the presence of CAN were 14.1 and 51.6 for the adiponectin 2nd, 3rd tertiles when compared with first tertile (p-value for trend = 0.022).ConclusionsIn the present study, the higher serum adiponectin levels and HOMA-IR were associated with an increased risk for the presence of CAN. Also, the CAN score correlated with the serum adiponectin. Serum adipocytokines such as leptin and TNF-alpha were significantly correlated with parameters of HRV, representative markers of CAN. Future prospective studies with larger number of patients are required to establish a direct relationship between plasma adipocytokine concentrations and the development or severity of CAN.

【 授权许可】

Unknown   
© Jung et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.