New Research on Heart Risk in Long-Standing Type 1 Diabetes: What Adipokines Tell Us

People with Type 1 diabetes face a higher risk of heart disease than the general population, even when blood sugar control is good. Researchers are searching for better ways to identify who is at greatest risk so that prevention efforts can be targeted more effectively.

Two hormones made by fat tissue—adiponectin and leptin—play roles in how the body manages metabolism and blood vessel health. This study examined whether measuring these hormones could help doctors better understand cardiovascular risk in people with long-standing Type 1 diabetes.

Researchers compared 124 adults with long-standing Type 1 diabetes to 59 people without diabetes matched by age and sex. They measured blood levels of both adiponectin and leptin, then looked at how these hormones related to cardiovascular risk using two different risk assessment tools: the Steno Type 1 Risk Engine and the 2019 European Society of Cardiology guidelines.

People with Type 1 diabetes had higher adiponectin levels than those without diabetes. Leptin levels were influenced by sex, and higher leptin showed a significant association with higher cardiovascular risk when using one risk tool (the ESC 2019 algorithm), but not with the other risk tool (ST1RE).

Sex appeared to influence how these hormones relate to cardiovascular risk, suggesting that the biology may differ between men and women. However, adiponectin itself did not show a clear association with either risk assessment method.

This is early research from a relatively small group of participants. The findings suggest that leptin warrants further investigation as a potential piece of the cardiovascular risk puzzle in Type 1 diabetes, particularly when using certain risk assessment methods. However, these results do not yet mean that measuring adiponectin or leptin will become part of routine clinical care.

The inconsistency between the two risk assessment tools—with leptin showing a link to one but not the other—shows that more research is needed to clarify how these hormones actually influence heart health in Type 1 diabetes. Sex differences also deserve closer attention in future studies.

If you have Type 1 diabetes, your cardiovascular risk is best assessed using established clinical tools and conversations with your healthcare team about your individual situation, blood pressure, cholesterol levels, and other known risk factors.

Larger, longer studies are needed to confirm these findings and understand the biological mechanisms that connect leptin and adiponectin to heart disease risk in Type 1 diabetes. Researchers will also want to explore why the two risk assessment tools gave different results and what sex differences mean for prevention strategies.

Understanding the role of adipokines may one day help doctors better identify and protect people with Type 1 diabetes who face the highest cardiovascular risk, but we are not there yet.

Source: Medicina (Kaunas, Lithuania). Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.