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

详细信息    查看全文

• 作者：Christian S. Hansen^a ; ^{csvh@steno.dk} ; Jan S. Jensen^b ; Martin Ridderstrå ; le^c ; Dorte Vistisen^a ; Marit E. Jø ; rgensen^a ; Jesper Fleischer^d
• 关键词：Vitamin B12 ; Cardiovascular autonomic neuropathy ; Type 2 diabetes ; Complications ; Metformin ; Proton pump inhibitors
• 刊名：Journal of Diabetes and its Complications
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：31
• 期：1
• 页码：202-208
• 全文大小：392 K
• 卷排序：31

文摘

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.Methods469 ambulatory type 2 diabetes patients (mean diabetes duration 10.0 years (IQR 5.0;17.0), mean age 59.0 years (SD 11.6), 63% men, mean B12 289.0 pmol/l (IQR 217;390)) were screened for CAN using three cardiovascular reflex tests, five minute resting heart rate (5 min RHR) and heart rate variability indices.ResultsSerum 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 25 pmol/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 5 min RHR of 0.25 beats per minute (95% CI − 0.47; − 0.03, p = 0.025).ConclusionVitamin 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.