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[Adipokines and the cardiorespiratory system in young patients with type 1 diabetes mellitus]
O I Vengrzhinovskaya1, I Z Bondarenko1, O A Shatskaya1
1National Medical Research Center for Endocrinology.
Insights
Young patients with type 1 diabetes mellitus (T1DM) show early heart changes and altered adipokine levels, indicating a higher risk for cardiovascular disease (CVD). This highlights the need for proactive screening and preventive strategies in T1DM management.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Research
Context:
- Type 1 diabetes mellitus (T1DM) affects working-age individuals, necessitating strategies to prevent premature cardiovascular disease (CVD).
- Early detection of CVD complications in T1DM is crucial for public health and maintaining quality of life.
Purpose:
- To evaluate the predictive capability of adipokines for identifying young T1DM patients requiring detailed cardiovascular assessment.
- To explore the relationship between adipokines and preclinical cardiac changes in T1DM.
Summary:
- This study analyzed 98 participants (70 T1DM, 28 controls), assessing cardiorespiratory function, myocardial structure, and adipokine profiles.
- T1DM patients exhibited reduced aerobic capacity, signs of myocardial remodeling (e.g., increased left ventricular wall thickness), and altered adipokine levels (higher resistin/visfatin, lower adiponectin).
- Significant correlations were observed between specific adipokines (visfatin, adiponectin) and cardiac structural changes in T1DM.
Impact:
- Findings suggest that adipokine profiles can help identify young T1DM patients at high risk for CVD.
- This research provides a basis for personalized preventive therapy timing in T1DM management.
- Early identification of cardiac changes in T1DM can guide interventions to prevent long-term disability.
Abstract:
Early screening of complications of diabetes mellitus (DM) is one of the priorities for public health. Most patients with type 1 diabetes mellitus (T1DM) are patients of working age. New strategies for the primary prevention of cardiovascular disease (CVD) are needed to prevent their early disability.
Aim:
To assess the predictive value of adipokines in relation to a personalized approach to the need for an in-depth examination of young patients with T1DM.
Materials And Methods:
The study included 98 patients without CVD: 70 patients with T1DM (mean age 26.4±8.1 years) and 28 patients without DM (mean age 27±9 years). All patients underwent a general clinical examination, the levels of adipokines were determined, ergospirometry, echocardiography, and bioimpedancemetry were performed.
Results:
Changes in the cardiorespiratory system in patients with T1DM were revealed, in comparison with persons without T1DM: anaerobic threshold was reached faster (p=0.001), maximum oxygen consumption was lower (p=0.048), metabolic equivalent was reduced (p=0.0001). Signs of myocardial remodeling were found in the T1DM group: there was an increase in the relative wall thickness (p=0.001), the posterior wall of the left ventricle (p=0.001), myocardial mass index (p=0.049), in comparison with persons without T1DM. Changes in the adipokines system were revealed: higher levels of resistin (p=0.002) and visfatin (p=0.001), lower level of adiponectin (p=0.040) in T1DM. A positive correlation was found between posterior wall of the left ventricle and visfatin (p=0.014) and a negative relationship between adiponectin and relative wall thickness (p=0.018) in T1DM.
Conclusion:
In T1DM, even at a young age, there are multifactorial changes in the heart, which can be detected even at the preclinical stage. The data obtained can be used to identify groups of patients at high risk of developing dangerous CVD in T1DM, which can form the basis for determining the timing of the start of preventive therapy.
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