Epidemiology of Cardiovascular Disease in Patients with Type 1 Diabetes: European Perspective

Matteucci, Elena; Giampietro, Ottavio

doi:10.1055/s-0034-1367062

Cited by 13 publications

(7 citation statements)

References 40 publications

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“…In the present study we used db/db mice as a rodent model of type 2 diabetes and compared the circulating TMAO levels to those in lean control mice. In addition, TMAO levels were measured in patients undergoing percutaneous coronary intervention, because TMAO has been associated to cardiovascular risks and cardiovascular diseases are the most common cause of death in people with diabetes [17,18]. Our results support the hypothesis of TMAO as a cardiovascular risk marker and warrant further investigation into the application of TMAO in diabetes research.…”

Section: Abstract ▼supporting

confidence: 66%

Diabetes is Associated with Higher Trimethylamine N-oxide Plasma Levels

Dambrova

Latkovskis

Kuka

et al. 2016

Exp Clin Endocrinol Diabetes

190

162

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Recent studies have revealed strong associations between systemic trimethylamine N-oxide (TMAO) levels, atherosclerosis and cardiovascular risk. In addition, plasma L-carnitine levels in patients with high TMAO concentrations predicted an increased risk for cardiovascular disease and incident major adverse cardiac events. The aim of the present study was to investigate the relation between TMAO and L-carnitine plasma levels and diabetes. Blood plasma samples were collected from 12 and 20 weeks old db/db mice and patients undergoing percutaneous coronary intervention. Diabetic compared to non-diabetic db/L mice presented 10-fold higher TMAO, but lower L-carnitine plasma concentrations at 12 weeks of age. After 8 weeks of observation, diabetic db/db mice had significantly increased body weight, insulin resistance and TMAO concentration in comparison to non-diabetic control. In 191 patients undergoing percutaneous coronary intervention the median (interquartile range) plasma concentration of TMAO was 1.8 (1.2-2.6) µmol/L. Analysis of the samples showed a bivariate association of TMAO level with age, total cholesterol and L-carnitine. The multivariate linear regression analysis revealed that, in addition to L-carnitine as the strongest predictor of log transformed TMAO (p<0.001), the parameters of age, diabetes status and body mass index (BMI) were independently associated with increased log transformed TMAO levels (p<0.01).Our data provide evidence that age, diabetes and BMI are associated with higher TMAO levels independently of L-carnitine. These data support the hypothesis of TMAO as a cardiovascular risk marker and warrant further investigation of TMAO for diabetes research applications.

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Section: Abstract ▼supporting

confidence: 66%

Diabetes is Associated with Higher Trimethylamine N-oxide Plasma Levels

Dambrova

Latkovskis

Kuka

et al. 2016

Exp Clin Endocrinol Diabetes

190

162

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“…Contradictory data exist concerning the pharmacological outcomes of L-carnitine treatment in diabetes mellitus, which is a widespread metabolic disease characterised by hyperglycemia [33] and associated with severe complications, including cardiovascular disease and dyslipidemia [34,35]. In type 2 diabetic patients, L-carnitine improves insulin sensitivity and increases the amount of whole-body glucose utilisation and glucose oxidation [36][37][38].…”

Section: Possible Advantages Of L-carnitine Supplementation In Diabetmentioning

confidence: 99%

“…Because fatty acid metabolism is the main source of energy for muscle cells, including cardiomyocytes, the effects of L-carnitine have been evaluated for the treatment of different cardiovascular diseases [44], which are the most common causes of death in people with diabetes [34,35]. The evidence in support of the cardioprotective effectiveness of L-carnitine is equivocal.…”

Section: L-carnitine Supplementation In Heart Diseases ▼mentioning

confidence: 99%

Risks and Benefits of Carnitine Supplementation in Diabetes

Dambrova

Liepinsh

2014

Exp Clin Endocrinol Diabetes

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L-carnitine is a very popular food supplement due to its safety profile, antioxidant-type activity and suggested effects on energy metabolism pathways. L-carnitine participates in both fatty acid transport pathways and the export of acetyl groups out of the mitochondria. However, contradictory data exist concerning the pharmacological outcomes of L-carnitine treatment in diabetes mellitus, which is a highly prevalent metabolic disease characterised by hyperglycemia and associated with severe complications, including cardiovascular disease and dyslipidemia. Recently, the L-carnitine-derived metabolites, acylcarnitines and trimethylamine-N-oxide, have been associated with increased cardio-metabolic risks. This review aims to highlight the possible risks and benefits of L-carnitine supplementation.

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“…Diabetes is associated with excess cardiovascular morbidity and mortality as well as increased healthcare expenses (1,2,3,4). Moreover, subclinical heart disease is also prevalent in patients with diabetes (5,6,7).…”

Section: Introductionmentioning

confidence: 99%

suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

Theilade

Rossing

Eugen‐Olsen

et al. 2016

European Journal of Endocrinology

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Aim Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods. Methods In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates. Results Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s′, and with impaired diastolic measures a′ and e′/a′ (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e′/a′), both remained independently associated with suPAR levels (P=0.012). Conclusions In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.

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Epidemiology of Cardiovascular Disease in Patients with Type 1 Diabetes: European Perspective

Cited by 13 publications

References 40 publications

Diabetes is Associated with Higher Trimethylamine N-oxide Plasma Levels

Diabetes is Associated with Higher Trimethylamine N-oxide Plasma Levels

Risks and Benefits of Carnitine Supplementation in Diabetes

suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

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