Serum apolipoprotein A-1 concentrations and the prevalence of cardiovascular autonomic neuropathy in individuals with type 2 diabetes

• Published in: Journal of diabetes and its complications Vol. 32; no. 4; pp. 357 - 361
• Main Authors: Chung, Jin Ook, Park, Seon-Young, Han, Ji Hyun, Cho, Dong Hyeok, Chung, Dong Jin, Chung, Min Young
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2018; Elsevier Limited
• Subjects: Apolipoproteins; Biochemistry; Blood diseases; C-reactive protein; Cholesterol; Cytokines; Diabetes; Diabetic neuropathies; Diabetic neuropathy; Diabetic retinopathy; Fibrinogen; Health risk assessment; Heart rate; Hypertension; Lipids; Low density lipoprotein receptors; Pathogenesis; Proteins; Statistical analysis; Triglycerides; Type 2 diabetes mellitus; Urine; United States > US; Japan; Diabetic neuropathies; C-reactive protein; Type 2 diabetes mellitus; Apolipoproteins; Fibrinogen
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2018.01.006

To evaluate the relationship between levels of serum apolipoproteins and the prevalence of cardiovascular autonomic neuropathy (CAN) in type 2 diabetes. In total, 3199 individuals with type 2 diabetes were investigated in a cross-sectional study. The diagnosis of CAN was made based on the results of a cardiovascular reflex test. Serum apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) levels were measured. Serum apoA-1 levels were significantly low in individuals with CAN, but there was no significant association between serum apoB levels and CAN. According to the degree of cardiovascular autonomic dysfunction, the average apoA-I levels were significantly different after adjusting for other covariates (normal, 1.32 g/l, 95% confidence interval [CI] 1.30–1.35; early, 1.29 g/l, 95% CI 1.27–1.31; definite, 1.27 g/l, 95% CI 1.25–1.30; P for trend = 0.010). In the multivariable analysis, the statistically significant association between apoA-I and CAN remained after adjusting for the risk factors (odds ratio per standard deviation increase in the log-transformed value, 0.65; 95% CI, 0.43–0.97, P = 0.036). Additional adjustments for serum high-sensitivity C-reactive protein (or fibrinogen) concentrations eliminated this relationship. Serum apoA-I levels are inversely associated with the prevalence of CAN in individuals with type 2 diabetes. Our data also suggest that a putatively increased risk of CAN associated with decreased apoA-I levels might be mediated by correlated increases in the levels of inflammatory markers.