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Vitamin B12 deficiency is associated with cardiovascular autonomic neuropathy in patients with type 2 diabetes

Hansen, Christian S LU ; Jensen, Jan S; Ridderstråle, Martin LU ; Vistisen, Dorte; Jørgensen, Marit E and Fleischer, Jesper (2017) In Journal of Diabetes and its Complications 31(1). p.202-208
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... (More)

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.

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author
publishing date
type
Contribution to journal
publication status
published
in
Journal of Diabetes and its Complications
volume
31
issue
1
pages
202 - 208
publisher
Elsevier
external identifiers
  • Scopus:84994756426
ISSN
1873-460X
DOI
10.1016/j.jdiacomp.2016.08.025
language
English
LU publication?
no
id
2f613013-1fb0-4193-9903-a9ab12e1faf1
date added to LUP
2016-10-04 16:12:09
date last changed
2017-02-06 08:19:29
@article{2f613013-1fb0-4193-9903-a9ab12e1faf1,
  abstract     = {<p>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.</p><p>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.</p><p>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&lt;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).</p><p>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.</p>},
  author       = {Hansen, Christian S and Jensen, Jan S and Ridderstråle, Martin and Vistisen, Dorte and Jørgensen, Marit E and Fleischer, Jesper},
  issn         = {1873-460X},
  language     = {eng},
  number       = {1},
  pages        = {202--208},
  publisher    = {Elsevier},
  series       = {Journal of Diabetes and its Complications},
  title        = {Vitamin B12 deficiency is associated with cardiovascular autonomic neuropathy in patients with type 2 diabetes},
  url          = {http://dx.doi.org/10.1016/j.jdiacomp.2016.08.025},
  volume       = {31},
  year         = {2017},
}