Association of cardiac autonomic dysfunction with higher levels of plasma lipid metabolites in recent-onset type 2 diabetes
Cardiac autonomic neuropathy affects about 20% of patients with diabetes and increases their risk of mortality. Besides high blood glucose levels, there is emerging evidence that dyslipidemia (unhealthy blood lipid levels) might also contribute to the damage of nerve fibers in the heart and blood vessels. However, there has not been assessed the relationship between reduced heart rate variability, as hall mark of cardiac autonomic neuropathy, and lipid metabolites in diabetic patients so far.
In this new study, Prof. Dr. Ziegler and colleagues from the German Diabetes Center explored the connection between diminished heat rate variability and distinct lipid metabolites in recent-onset type 2 diabetes (T2D) in contrast to type 1 diabetes (T1D). Their analysis used plasma metabolite measurements and heart rate variability indices of participants from the German Diabetes Study baseline cohort, who were newly diagnosed with either T1D or T2D.
The study benefits from a broad metabolic characterization of individuals with well-controlled and well-documented forms of diabetes. Furthermore, methods as well as statistics were adjusted for various potential confounders.
The results revealed that higher plasma levels of specific phosphatidylcholines and sphingomyelins are linked with reduced heart rate variability in T2D. In contrast, no such association was found in patients with T1D. This suggests that disruption of the lipid metabolism in the early development of cardiac autonomic neuropathy might be specific to T2D.
To conclude, monitoring lipid metabolite levels could have potential for various clinical applications, such as the prediction of the long-term development of cardiac autonomic neuropathy.
Ziegler D, Strom A, Straßburger K, Knebel B, Bönhof GJ, Kotzka J et al.: Association of cardiac autonomic dysfunction with higher levels of plasma lipid metabolites in recent-onset type 2 diabetes. (2021) Diabetologia | https://doi.org/10.1007/s00125-020-05310-5