Cardiovascular autonomic neuropathy in Type 1 diabetes was associated with 4.2% lower femoral neck bone mineral density (95% CI -8.0 to -0.2; P=0.038) compared to those without the condition.
Observational (n=329)
Is cardiovascular autonomic neuropathy associated with altered bone metabolism in people with Type 1 diabetes?
Cardiovascular autonomic neuropathy in Type 1 diabetes is associated with reduced bone mineral density and increased parathyroid hormone levels, suggesting a potential link to increased osteoporosis risk.
Effect estimate: -4.2% (95% CI -8.0 to -0.2)
p-value: p=0.038
AIM: To investigate the association between cardiovascular autonomic neuropathy and bone metabolism in people with Type 1 diabetes. METHODS: We assessed cardiovascular autonomic neuropathy in 329 people with Type 1 diabetes according to heart rate response to deep breathing, to standing and to the Valsalva manoeuvre, and 2-min resting heart rate. More than one pathological non-resting test was defined as cardiovascular autonomic neuropathy. Bone mineral density of the femoral neck (BMDfn) was assessed by dual energy X-ray absorptiometry. Serum parathyroid hormone levels and other bone markers were measured. RESULTS: . In all, 36% had cardiovascular autonomic neuropathy. Participants with cardiovascular autonomic neuropathy had 4.2% (95% CI -8.0 to -0.2; P=0.038) lower BMDfn and 33.6% (95% CI 14.3 to 53.8; P=0.0002) higher parathyroid hormone levels compared with participants without cardiovascular autonomic neuropathy in adjusted models. Higher resting heart rate remained associated with higher parathyroid hormone level and lower BMDfn after additional adjustment for eGFR (P<0.0001 and P = 0.042, respectively). CONCLUSIONS: The presence of cardiovascular autonomic neuropathy was associated with reduced BMDfn and increased levels of parathyroid hormone. Kidney function may either confound or mediate these findings. Cardiovascular autonomic neuropathy could be associated with increased risk of osteoporosis in Type 1 diabetes. Whether cardiovascular autonomic neuropathy directly affects bone metabolism detrimentally or if this association is mediated via decreased kidney function should be investigated further.
Hansen et al. (Thu,) conducted a observational in Type 1 diabetes (n=329). Cardiovascular autonomic neuropathy vs. No cardiovascular autonomic neuropathy was evaluated on Bone mineral density of the femoral neck (BMDfn) (-4.2%, 95% CI -8.0 to -0.2, p=0.038). Cardiovascular autonomic neuropathy in Type 1 diabetes was associated with 4.2% lower femoral neck bone mineral density (95% CI -8.0 to -0.2; P=0.038) compared to those without the condition.