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

Hansen, Christian S ; 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
; ; ; ; and
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
  • pmid:27638143
  • 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
2024-04-19 09:56:56
@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}},
  doi          = {{10.1016/j.jdiacomp.2016.08.025}},
  volume       = {{31}},
  year         = {{2017}},
}