Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes
ABSTRACT: Background: Coronary microvascular dysfunction (CMD) is a significant complication in type 2 diabetes (T2D) and may be more common in women. We aimed to evaluate the sex differences and sex-specific clinical determinants of CMD in adults with T2D without prevalent cardiovascular disease....
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664724011591 |
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| author | Jian L. Yeo Abhishek Dattani Joanna M. Bilak Alice L. Wood Lavanya Athithan Aparna Deshpande Anvesha Singh J.Ranjit Arnold Emer M. Brady David Adlam John D. Biglands Peter Kellman Hui Xue Thomas Yates Melanie J. Davies Gaurav S. Gulsin Gerry P. McCann |
| author_facet | Jian L. Yeo Abhishek Dattani Joanna M. Bilak Alice L. Wood Lavanya Athithan Aparna Deshpande Anvesha Singh J.Ranjit Arnold Emer M. Brady David Adlam John D. Biglands Peter Kellman Hui Xue Thomas Yates Melanie J. Davies Gaurav S. Gulsin Gerry P. McCann |
| author_sort | Jian L. Yeo |
| collection | DOAJ |
| description | ABSTRACT: Background: Coronary microvascular dysfunction (CMD) is a significant complication in type 2 diabetes (T2D) and may be more common in women. We aimed to evaluate the sex differences and sex-specific clinical determinants of CMD in adults with T2D without prevalent cardiovascular disease. Methods: Single center pooled analysis of four prospective studies comparing asymptomatic people with T2D and controls. All subjects underwent comprehensive cardiovascular phenotyping with myocardial perfusion reserve (MPR) quantified with perfusion cardiovascular magnetic resonance (CMR). Participants with silent coronary disease were excluded. Multivariable linear regression was performed to identify determinants of MPR with an interaction term for sex. Results: Four hundred and seventy-nine T2D (age 57 ± 11 years, 42% [202/479] women) were compared with 116 controls (age 53 ± 11 years, 41% [48/116] women). Men with T2D, but not women, demonstrated worse systolic function and higher extracellular volume fraction than controls. MPR was significantly lower in T2D than controls (women, 2.6 ± 0.9 vs 3.3 ± 1.0, p < 0.001; men, 3.1 ± 0.9 vs 3.5 ± 1.0, p = 0.004), and lower in women than men with T2D (p < 0.001). More women than men with T2D had MPR <2.5 (46% [79/202] vs 26% [64/277], p < 0.001). There was a significant interaction between sex and body mass index (BMI) for MPR (p interaction <0.001). Following adjustment for clinical risk factors, inverse association with MPR were BMI in women (β = −0.17, p = 0.045) and systolic blood pressure in men (β = −0.14, p = 0.049). Conclusion: Among asymptomatic adults with T2D, women had a greater prevalence of CMD than men. Risk factors modestly but significantly associated with CMD in asymptomatic people with T2D were BMI among women and systolic blood pressure among men. |
| format | Article |
| id | doaj-art-9241ecc84cc14745a4b85d2f4dbb34ac |
| institution | Kabale University |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-9241ecc84cc14745a4b85d2f4dbb34ac2025-01-09T06:13:15ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-01271101132Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetesJian L. Yeo0Abhishek Dattani1Joanna M. Bilak2Alice L. Wood3Lavanya Athithan4Aparna Deshpande5Anvesha Singh6J.Ranjit Arnold7Emer M. Brady8David Adlam9John D. Biglands10Peter Kellman11Hui Xue12Thomas Yates13Melanie J. Davies14Gaurav S. Gulsin15Gerry P. McCann16Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomRadiology, University Hospitals of Leicester NHS Trust, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomNIHR Leeds Biomedical Research Centre and Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, United KingdomNational Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USANational Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USADiabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, United KingdomDiabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United KingdomDepartment of Cardiovascular Sciences, University of Leicester and the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom; Corresponding author.ABSTRACT: Background: Coronary microvascular dysfunction (CMD) is a significant complication in type 2 diabetes (T2D) and may be more common in women. We aimed to evaluate the sex differences and sex-specific clinical determinants of CMD in adults with T2D without prevalent cardiovascular disease. Methods: Single center pooled analysis of four prospective studies comparing asymptomatic people with T2D and controls. All subjects underwent comprehensive cardiovascular phenotyping with myocardial perfusion reserve (MPR) quantified with perfusion cardiovascular magnetic resonance (CMR). Participants with silent coronary disease were excluded. Multivariable linear regression was performed to identify determinants of MPR with an interaction term for sex. Results: Four hundred and seventy-nine T2D (age 57 ± 11 years, 42% [202/479] women) were compared with 116 controls (age 53 ± 11 years, 41% [48/116] women). Men with T2D, but not women, demonstrated worse systolic function and higher extracellular volume fraction than controls. MPR was significantly lower in T2D than controls (women, 2.6 ± 0.9 vs 3.3 ± 1.0, p < 0.001; men, 3.1 ± 0.9 vs 3.5 ± 1.0, p = 0.004), and lower in women than men with T2D (p < 0.001). More women than men with T2D had MPR <2.5 (46% [79/202] vs 26% [64/277], p < 0.001). There was a significant interaction between sex and body mass index (BMI) for MPR (p interaction <0.001). Following adjustment for clinical risk factors, inverse association with MPR were BMI in women (β = −0.17, p = 0.045) and systolic blood pressure in men (β = −0.14, p = 0.049). Conclusion: Among asymptomatic adults with T2D, women had a greater prevalence of CMD than men. Risk factors modestly but significantly associated with CMD in asymptomatic people with T2D were BMI among women and systolic blood pressure among men.http://www.sciencedirect.com/science/article/pii/S1097664724011591Type 2 diabetesCoronary microvascular dysfunctionMyocardial perfusionCardiovascular magnetic resonance |
| spellingShingle | Jian L. Yeo Abhishek Dattani Joanna M. Bilak Alice L. Wood Lavanya Athithan Aparna Deshpande Anvesha Singh J.Ranjit Arnold Emer M. Brady David Adlam John D. Biglands Peter Kellman Hui Xue Thomas Yates Melanie J. Davies Gaurav S. Gulsin Gerry P. McCann Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes Journal of Cardiovascular Magnetic Resonance Type 2 diabetes Coronary microvascular dysfunction Myocardial perfusion Cardiovascular magnetic resonance |
| title | Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes |
| title_full | Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes |
| title_fullStr | Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes |
| title_full_unstemmed | Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes |
| title_short | Sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes |
| title_sort | sex differences and determinants of coronary microvascular function in asymptomatic adults with type 2 diabetes |
| topic | Type 2 diabetes Coronary microvascular dysfunction Myocardial perfusion Cardiovascular magnetic resonance |
| url | http://www.sciencedirect.com/science/article/pii/S1097664724011591 |
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