Objective: The aim of the study was to evaluate NADH dehydrogenase [ubiquinone] iron–sulfur protein 8 (NDUFS8) serum concentration as a marker of Complex I, and the relationship with insulin resistance in type 1 diabetes mellitus (T1DM). Design and methods: Participants were adults with T1DM, recruited over the course of 1 year (2018–2019). NDUFS8 protein serum concentration was measured using the ELISA test. Insulin resistance was evaluated with indirect marker estimated glucose disposal rate (eGDR). The group was divided on the base of median value of eGDR (higher eGDR—better insulin sensitivity). Results: The study group consists of 12 women and 24 men. Medians of eGDR and NDUFS8 protein concentration are 7.6 (5.58–8.99) mg/kg/min and 2.25 (0.72–3.81) ng/mL, respectively. The group with higher insulin sensitivity has higher NDUFS8 protein serum concentration, lower waist to hip ratio (WHR), body mass index (BMI), and they are younger. A negative correlation is observed between NDUFS8 protein serum concentration and WHR (rs = −0.35, p = 0.03), whereas a positive correlation is observed between NDUFS8 protein serum concentration and eGDR (rs = 0.43, p = 0.008). Univariate logistic regression shows a significant association between insulin sensitivity and lower age, as well as a higher NDUFS8 serum level. A multivariate logistic regression model confirms the significance (AOR 2.38 (1.04–5.48). p = 0.042). Multivariate linear regression confirms a significant association between insulin sensitivity and better mitochondrial function (beta = 0.54, p = 0.003), independent of age, duration of diabetes, and smoking. Conclusions: Higher NDUFS8 protein serum concentration is associated with higher insulin sensitivity among adults with T1DM.
: The most common cause of mortality among people with type 1 diabetes is cardiovascular diseases. Arterial stiffness allows predicting cardiovascular complications, cardiovascular mortality, and all-cause mortality. There are different ways to measure arterial stiffness; the gold standard is pulse wave velocity. Arterial stiffness is increased in people with type 1 diabetes compared to healthy controls. It increases with age and duration of type 1 diabetes. Arterial stiffness among people with type 1 diabetes has a positive association with systolic blood pressure, obesity, glycated hemoglobin, waist circumference, and waist to hip ratio. It has a negative correlation with estimated glomerular filtration rate, high-density lipoprotein, and the absence of carotid plaques. The increased arterial stiffness could be the result of insulin resistance, collagen increase due to inadequate enzymatic glycation, endothelial and autonomic dysfunction. The insulin-induced decrease in arterial stiffness is impaired in type 1 diabetes. There are not enough proofs to use pharmacotherapy in the prevention of arterial stiffness, but some of the medicaments have obtained promising results in single studies, for example, renin-angiotensin-aldosterone system inhibitors, statins, and SGLT2 inhibitors. The main form of prevention of arterial stiffness progression remains glycemic control and a healthy lifestyle.
The non-dipping pattern is nighttime systolic blood pressure (SBP) fall of less than 10%. Several studies showed that the non-dipping pattern, increased mean platelet volume (MPV), and platelet distribution width (PDW) are associated with elevated cardiovascular risk. Hypertensives with the non-dipping pattern have higher MPV than the dippers but this relationship was never investigated among people with type 1 diabetes mellitus (T1DM). This study aimed to investigate the association between the central dipping pattern and platelet morphology in T1DM subjects. We measured the central and brachial blood pressure with a validated non-invasive brachial oscillometric device—Arteriograph 24—during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The group was divided based on the central dipping pattern for the dippers and the non-dippers. From a total of 62 subjects (32 males) aged 30.1 (25.7–37) years with T1DM duration 15.0 (9.0–20) years, 36 were non-dippers. The non-dipper group had significantly higher MPV (MPV (10.8 [10.3–11.5] vs 10.4 [10.0–10.7] fl; p = 0.041) and PDW (13.2 [11.7–14.9] vs 12.3 [11.7–12.8] fl; p = 0.029) than dipper group. Multivariable logistic regression revealed that MPV (OR 3.74; 95% CI 1.48–9.45; p = 0.005) and PDW (OR 1.91; 95% CI 1.22–3.00; p = 0.005) were positively associated with central non-dipping pattern adjusting for age, sex, smoking status, daily insulin intake, and height. MPV and PDW are positively associated with the central non-dipping pattern among people with T1DM.
Arterial stiffness (AS) and non-dipping pattern are early predictors of cardiovascular diseases but are not used in clinical practice. We aimed to assess if the International Index of Erectile Function (IIEF-5) score could be a useful tool to predict AS and non-dipping pattern in subjects with type 1 diabetes (T1DM). The study group consisted of adults with T1DM. Aortic pulse wave velocity (PWV Ao), central systolic blood pressure, and pulse were measured with a brachial oscillometric device (Arteriograph 24). ED was assessed by the IIEF-5. A comparison between the groups with and without ED was performed. Of 34 investigated men with T1DM, 12 (35.3%) suffered from ED. The group with ED had higher mean 24h pulse (77.7 [73.7-86.5] vs 69.9 [64.0-76.8]/min; p=0.04, nighttime PWV Ao (8.1 [6.8-8.5] vs 6.8 [6.1-7.5]m/s; p=0.015) and prevalence of non-dipping SBP Ao pattern (11 [91.7] vs 12 [54.5]%; p=0.027) than individuals without ED. The presence of ED detected a central non-dipping pattern with a sensitivity of 47.8% and a specificity of 90.9%. ED is associated with a central non-dipping pattern, increased AS, and a mean 24h pulse among people with T1DM.
BackgroundPeople with type 1 diabetes mellitus (T1DM) have higher cardiovascular risk (CVR) compared to those from the general population. One of the markers of elevated CVR is a non-dipping pattern. Mean platelet volume (MPV) and platelet distribution width (PDW) are related to platelets' activation. Aortic systolic blood pressure (SBP Ao) has a better predictive value for cardiovascular disease than brachial systolic blood pressure (SBP Br). Hypertensives with non-dipping pattern have higher MPV than dippers. However, this relationship was never investigated among people with T1DM. This study aimed to investigate the association between central dipping pattern and platelets morphology in subjects with T1DM.MethodsWe measured SBPAo and SBPBr with a validated non-invasive brachial oscillometric device - Arteriograph 24 (TensioMed Ltd., Budapest, Hungary) - during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The non-dipping pattern was defined as a nocturnal SBP Ao fall of less than 10%. We collected medical history, anthropometrical features, and laboratory results. The group was divided based on the dipping pattern for dippers and non-dippers. ResultsFrom total 62 subjects (32 males) aged 30.1 (25.7-37) years with T1DM duration 15.0 (9.0-20) years, 36 were non-dippers based on SBP Ao. Non-dipper group had significantly higher MPV (10.4 [10-10.7] fl vs 10.9 [10.3-11.5] fl; p = 0.03) and PDW (12.3 [11.7-12.8] fl vs 13.95 [11.7-15.1] fl; p=0.02) than dipper group. The groups did not differ in classic risk factors. Multivariate logistic regression revealed that MPV (OR: 3.74; 95% CI =1.48-9.45; p = 0.005) and daily insulin intake (OR: 445.11; 95% CI = 4.25 - 46597.42; p = 0.01) were independently positively associated with non-dipping pattern based on SBP Ao. PDW was also independently positively related to central non-dipping pattern (OR: 1.91; 95% CI = 1.22 - 3.00; p = 0.005).ConclusionsT1DM subjects with central non-dipping pattern have higher values of MPV and PDW than dippers. MPV and PDW are independently positively associated with SBP Ao non-dipping pattern among people with T1DM.
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