Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type-2 diabetic patients treated w
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RESEARCH ARTICLE
Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type‑2 diabetic patients treated with oral antidiabetic drugs M. R. Jasmine1, Nivedita Nanda1* , Jayaprakash Sahoo2, S. Velkumary3 and G. K. Pal3
Abstract Background: An increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI). We explored the link of osteoprotegerin with cardiovagal modulation in T2DM. Methods: We assessed fasting serum OPG, high-sensitive C-reactive protein (hsCRP), glucose, insulin and lipid profile in patients having T2DM receiving oral antidiabetic drugs (OAD) (n = 42) compared with age, gender and body composition-matched healthy participants without diabetes (n = 42). Rate pressure product (RPP), spectral indices of heart rate variability (HRV) and body composition were recorded in both the groups. Association of HOMA-IR and OPG with various parameters were assessed. Results: Osteoprotegerin, HOMA-IR, hsCRP, coronary lipid risk factor were significantly increased, markers of cardiovagal modulation (TP, SDNN, RMSSD) were considerably decreased, ratio of low-frequency to high-frequency (LH-HF ratio), the indicator of SVI, and RPP, the marker of myocardial work stress were significantly higher in patients with diabetes, suggesting an overall elevated CVD risks in them. HOMA-IR was correlated with RMSSD, lipid risk factors and OPG. Rise in OPG was correlated with decreased cardiovagal modulation in patients with diabetes. There was significant contribution of OPG in decreasing TP, suggesting impaired cardiovagal modulation. Conclusion: T2DM patients receiving OAD had higher cardiometabolic risks compared to age, gender and body composition-matched healthy individuals. Increased level of OPG is linked to decreased cardiovagal modulation in T2DM patients. Keywords: Type-2 diabetes mellitus, Sympathovagal imbalance, Cardiovagal modulation, Heart rate variability, Osteoprotegerin, Cardiometabolic risks Background A recent report with pooled data from 751 studies consisting of 4,372,000 adults from 146 countries has projected that the total number of diabetic adults worldwide *Correspondence: [email protected] 1 Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605 006, India Full list of author information is available at the end of the article
has increased from 108 million in 1980 to 422 million by 2014 and age-standardized diabetes prevalence has increased from 4.3 to 9.0% in men and 5.0 to 7.9% in women on a global scale [1]. India alone harbours 62 million of diabetics, making the country the diabetic capital of the world [2]. In spite of early diagnosis and treatment, type-2 diabetes mellitus (T2DM) is the leading cause of morbidity and mortality in India, and cardiovascular diseases (CVD) are the common complications of diabetes
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