Sex differences in coronary plaque composition evaluated by coronary computed tomography angiography in newly diagnosed Type 2 diabetes: association with low‐grade inflammation

Mrgan, Monija; Gram, Jeppe; Olsen, Michael Hecht; Dey, Damini; Nørgaard, Bjarne Linde; Sand, Niels Peter Rønnow

doi:10.1111/dme.13768

Cited by 8 publications

(8 citation statements)

References 28 publications

(39 reference statements)

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“…Women with diabetes might be in a more pro-thrombotic state than men, which may lead to lacunes and atrophy, and a more general decline in brain health, even when the prevalence of diabetes is similar in both sexes (Smith et al, 2012 ; Neergaard-Petersen et al, 2014 ). They generally also have greater levels of systemic inflammation and more oxidative stress than men with diabetes, leading to impaired vascular reactivity, which is specifically associated with the occurrence of lacunes (Mrgan et al, 2018 ). Sex-dependent differences in vascular physiology may therefore render women more susceptible to the cerebrovascular complications of diabetes, and also lead to functional decline.…”

Section: Discussionmentioning

confidence: 99%

Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population

Thomas

Rhodius-Meester

Exalto

et al. 2022

Front. Aging Neurosci.

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IntroductionGlobally, women with dementia have a higher disease burden than men with dementia. In addition, women with diabetes especially are at higher risk for cognitive impairment and dementia compared to men with diabetes. Differences in the influence of diabetes on the cerebral vasculature and brain structure may contribute to these sex-specific differences. We examined sex-specific patterns in the relationship between diabetes and brain structure, as well as diabetes and cognitive function.MethodsIn total, 893 patients [age 79 ± 6.6 years, 446 (50%) women] from the Amsterdam Ageing Cohort with available data on brain structures (assessed by an MRI or CT scan) and cognitive function were included. All patients underwent a thorough standardized clinical and neuropsychological assessment (including tests on memory, executive functioning, processing speed, language). Brain structure abnormalities were quantified using visual scales.ResultsCross-sectional multivariable regression analyses showed that diabetes was associated with increased incidence of cerebral lacunes and brain atrophy in women (OR 2.18 (1.00–4.72) but not in men. Furthermore, diabetes was associated with decreased executive function, processing speed and language in women [B −0.07 (0.00–0.13), −0.06 (0.02–0.10) and −0.07 (0.01–0.12) resp.] but not in men.ConclusionsDiabetes is related to increased risk of having lacunes, brain atrophy and impaired cognitive function in women but not in men. Further research is required to understand the time trajectory leading up to these changes and to understand the mechanisms behind them in order to improve preventive health care for both sexes.

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Section: Discussionmentioning

confidence: 99%

Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population

Thomas

Rhodius-Meester

Exalto

et al. 2022

Front. Aging Neurosci.

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“… 32 , 44 In diabetic patients, women may have lower plaque volumes but enhanced systemic inflammation, which may cause the increased risk of developing plaques and worse plaque composition. 45 …”

Section: Discussionmentioning

confidence: 99%

“…Observational studies also demonstrated that women with diabetes had higher risk of CVD than male patients 32,44 . In diabetic patients, women may have lower plaque volumes but enhanced systemic inflammation, which may cause the increased risk of developing plaques and worse plaque composition 45 …”

Section: Discussionmentioning

confidence: 99%

Sex‐specific risk factors of carotid atherosclerosis progression in a high‐risk population of cardiovascular disease

Cheng

Zhou

Wang

et al. 2022

Clinical Cardiology

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Background The progression of carotid intima‐media thickness (cIMT) and plaques are associated with cardiovascular health, especially for high‐risk population of cardiovascular disease (CVD). Hypothesis Risk factors for atherosclerosis may vary by sex. This study aimed to investigate the sex‐specific risk factors of cIMT and plaque progression. Methods We selected subjects who were identified as high‐risk population of CVD, and collected their carotid ultrasound data and baseline characteristics. Linear regression and logistic regression analyses were used to identify risk factors for cIMT and plaque progression. Sex‐specific risk factors were identified respectively. Results A total of 7908 participants were included. The mean age was 57.75 ± 9.45 years and 61.51% were female. During mean follow‐up of 1.92 ± 0.89 years, the median annual cIMT change rate was −7.25 μm/year. Seven hundred and fifteen subjects free from plaques at baseline developed plaque. Age, smoking, hypertension, and diabetes were common risk factors for carotid atherosclerosis progression in all participants. Smoking and alcohol drinking were significantly associated with increased cIMT change in women, while hypertension and antihypertensive medication were significant in men. Increased total cholesterol and diabetes were significantly associated with new plaque presence in women, while smoking, increased triglyceride, and dyslipidemia were significant in men ( p ˂ .05 for all cases). The association of baseline cIMT and smoking with annual cIMT change rate and increased total cholesterol with new plaque presence were significantly differentiated between both sexes ( p for interaction ˂ .05). Conclusions The risk factors for cIMT and plaque progression differed by sex.

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“…Despite the global decline in mortality and incidence of CVD over the last decades, seen both in subjects with and without diabetes, the latter still experience a 2–3 times higher risk as compared to non-diabetic matched controls [1–3]. This higher risk, combined with the high prevalence of subjects that already have cardiovascular complications at the time of diabetes diagnosis [4–6], makes the screening for chronic complications highly recommended for all patients with type 2 diabetes (T2D). Early identification of complications can result in the prescription of more aggressive treatment regimen that have the potential to slow their natural progression.…”

Section: Introductionmentioning

confidence: 99%

Improved long-term cardiovascular outcomes after intensive versus standard screening of diabetic complications: an observational study

Morieri

Longato

Mazzucato

et al. 2019

Cardiovasc Diabetol

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Background Complication screening is recommended for patients with type 2 diabetes (T2D), but the optimal screening intensity and schedules are unknown. In this study, we evaluated whether intensive versus standard complication screening affects long-term cardiovascular outcomes. Methods In this observational study, we included 368 T2D patients referred for intensive screening provided as a 1-day session of clinical–instrumental evaluation of diabetic complications, followed by dedicated counseling. From a total of 4906 patients, we selected control T2D patients who underwent standard complication screening at different visits, by 2:1 propensity score matching. The primary endpoint was the 4p-MACE, defined as cardiovascular mortality, or non-fatal myocardial infarction, stroke, or heart failure. The Cox proportional regression analyses was used to compare outcome occurrence in the two groups, adjusted for residual confounders. Results 357 patients from the intensive screening group (out of 368) were matched with 683 patients in the standard screening group. Clinical characteristics were well balanced between the two groups, except for a slightly higher prevalence of microangiopathy in the intensive group (56% vs 50%; standardized mean difference 0.11, p = 0.1). Median follow-up was 5.6 years. The adjusted incidence of 4p-MACE was significantly lower in the intensive versus standard screening group (HR 0.70; 95% CI 0.52–0.95; p = 0.02). All components of the primary endpoint had nominally lower rates in the intensive versus standard screening group, which was particularly significant for heart failure (HR 0.43; 95% CI 0.22–0.83; p = 0.01). Conclusion Among T2D patients attending a specialist outpatient clinic, intensive complication screening is followed by better long-term cardiovascular outcomes. No significant effect was noted for cardiovascular and all-cause mortality and the benefit was mainly driven by a reduced rate of hospitalization for heart failure.

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Sex differences in coronary plaque composition evaluated by coronary computed tomography angiography in newly diagnosed Type 2 diabetes: association with low‐grade inflammation

Abstract: In people with newly diagnosed Type 2 diabetes, women had lower absolute coronary plaque volumes but a more unfavourable plaque composition and enhanced systemic inflammation compared with men.

Cited by 8 publications

References 28 publications

Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population

Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population

Sex‐specific risk factors of carotid atherosclerosis progression in a high‐risk population of cardiovascular disease

Improved long-term cardiovascular outcomes after intensive versus standard screening of diabetic complications: an observational study

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