Association between plasma apolipoprotein M and cardiac autonomic neuropathy in type 1 diabetes

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Aim: Diabetes may lead to severe complications e.g. cardiac autonomic neuropathy (CAN) characterized by an increased risk of cardiovascular mortality. CAN is diagnosed by a decreased heart rate viability (HRV). Sphingosine-1-Phosphate (S1P) carried by the HDL-associated apolipoprotein M (apoM) is linked to a reduction in the heart rate, and treatment with an S1P-agonist increases HRV. The present study aimed to investigate if plasma apoM was associated with an increased risk of CAN. Methods: The study includes 278 individuals with Type 1 Diabetes recruited from Steno Diabetes Center in Copenhagen from 2010 to 2012. Results: A change of 0.1 µM plasma apoM was associated with the diagnosis of CAN (Odds ratio: 1.11 (1.02; 1.21), p = 0.013). ApoM plasma levels were also positively associated with CAN when adjusted for age and gender (Odds ratio: 1.11 (1.02; 1.21), p = 0.013) as well as lipids, beta-blockers, blood pressure, and alcohol (Odds ratio: 1.14 (1.04; 1.26), p = 0.005) and Hbga1c and time with diabetes (Odds ratio: 1.13 (1.02; 1.25), p = 0.01). Plasma apoM was also associated with a significantly lower SDNN as well as high frequency power in all adjusted models. Conclusion: Increased plasma apoM was associated with an increased risk of CAN as well as a significant reduction in HRV indices. This could represent changes in parasympathetic activity, but, further studies are needed to also explore additional molecular alterations behind such observations.

TidsskriftDiabetes Research and Clinical Practice
Antal sider7
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The study was supported by the Novo Nordisk Foundation [#0053008 and #NNF13OC0003898] to CC.

Funding Information:
We acknowledge the outstanding technical assistance of Charlotte Wandel and Lis Schutt Nielsen. The study was supported by the Novo Nordisk Foundation [#0053008 and #NNF13OC0003898] to CC. AB and CC conceptualized the present study design. The Thousand&1 study was designed and collected by MTJ, CSH, and PR. The CAN analysis was performed by CSH. Data acquisition and interpretation in the present study were performed by MS, CSH, and CC. The first draft was written by MS and critically revised by AB, CSH, and CC. All authors read and approved the final version of the manuscript.

Publisher Copyright:
© 2022 Elsevier B.V.

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