Interrelationship between micronutrients and cardiovascular structure and function in type 2 diabetes

J Nutr Sci. 2021 Oct 4:10:e88. doi: 10.1017/jns.2021.82. eCollection 2021.

Abstract

Micronutrients are important for normal cardiovascular function. They may play a role in the increased risk of cardiovascular disease observed in people with type 2 diabetes (T2D) and T2D-related heart failure. The aims of this study were to (1) examine micronutrient status in people with T2D v. healthy controls; (2) assess any changes following a nutritionally complete meal replacement plan (MRP) compared with routine care; (3) determine if any changes were associated with changes in cardiovascular structure/function. This was a secondary analysis of data from a prospective, randomised, open-label, blinded end-point trial of people with T2D, with a nested case-control [NCT02590822]. Anthropometrics, cardiac resonance imaging and fasting blood samples (to quantify vitamins B1, B6, B12, D and C; and iron and ferritin) were collected at baseline and 12 weeks following the MRP or routine care. Comparative data in healthy controls were collected at baseline. A total of eighty-three people with T2D and thirty-six healthy controls were compared at baseline; all had micronutrient status within reference ranges. Vitamin B1 was higher (148⋅9 v. 131⋅7; P 0⋅01) and B6 lower (37⋅3 v. 52⋅9; P 0⋅01) in T2D v. controls. All thirty participants randomised to routine care and twenty-four to the MRP completed the study. There was an increase in vitamins B1, B6, D and C following the MRP, which were not associated with changes in cardiovascular structure/function. In conclusion, changes in micronutrient status following the MRP were not independently associated with improvements in cardiovascular structure/function in people with T2D.

Keywords: BMI, body mass index; CMR; CMR, cardiac magnetic resonance imaging; CVD, cardiovascular disease; Cardiovascular function; EF, ejection fraction; HF, heart failure; LV, left ventricular; Low calorie; Low-energy meal replacement plan; MRP, meal replacement plan; Micronutrients; PLP, pyridoxal 5-phosphate; RCT, randomised control trial; T2D, type 2 diabetes; Type 2 diabetes.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases*
  • Cardiovascular System*
  • Diabetes Mellitus, Type 2*
  • Humans
  • Micronutrients
  • Prospective Studies

Substances

  • Micronutrients

Associated data

  • ClinicalTrials.gov/NCT02590822