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

M. Mrgan*, J. Gram, M. Hecht Olsen, D. Dey, B. Linde Nørgaard, J. Gram, N. P. Rønnow Sand

*Corresponding author for this work

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Abstract

Aim: To determine differences in coronary plaque composition and inflammatory biomarkers between men and women with newly diagnosed Type 2 diabetes without known cardiovascular disease. Methods: A total of 88 people with newly diagnosed (<1 year) Type 2 diabetes underwent contrast-enhanced coronary computed tomography angiography. Advanced coronary plaque analysis was performed using semi-automated software. Plasma concentrations of inflammatory biomarkers were determined. Results: There were no significant differences between men (n=60) and women (n=28) regarding age or cardiovascular risk factors (all P>0.05). The median (quartiles) serum levels of fibrinogen [10.9 (9.8-12.6) μmol/l vs 9.7 (8.8-10.9) μmol/l], fibrin d-dimer [0.3 (0.2-0.4) mg/l vs 0.27 (0.2-0.4) mg/l] and C-reactive protein [3.1 (1.1-5.2) mg/l vs (0.8-2.6) 1.6 mg/l] were significantly higher in women (all P<0.05). Overall, men more often had multi-vessel involvement [28 men (47%) vs 4 women (14%)], and higher total plaque burden [median (quartiles) 11.6 (2.3-36.0)% vs 2.0 (0.4-5.4)%; both P<0.05]. The median (quartiles) total plaque volume [269.9 (62.6-641.9) mm3 vs 61.1 (7.6-239.9) mm3] and absolute calcified plaque volume [33.5 (8.3-148.3) mm3 vs 4.7 (0.9-17.3) mm3] were higher in men (both P<0.05). Women had a lower relative proportion of the calcified plaque component [median (quartiles) 7.8 (4.7-15.4)% vs 23.7 (8.4-31.1)%] and a higher relative proportion (median [quartiles]) of the non-low-density non-calfied plaque component [77.6 (66.0-86.0)% vs 63.6 (54.0-72.9)%; both P<0.05]. Conclusions: 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.

Original languageEnglish
JournalDiabetic Medicine
Volume35
Issue number11
Pages (from-to)1588-1595
ISSN0742-3071
DOIs
Publication statusPublished - Nov 2018

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Sex Characteristics
Type 2 Diabetes Mellitus
Computed Tomography Angiography
Serum

Keywords

  • Aged
  • Computed Tomography Angiography
  • Coronary Angiography/methods
  • Coronary Artery Disease/complications
  • Diabetes Mellitus, Type 2/complications
  • Diabetic Angiopathies/complications
  • Female
  • Humans
  • Inflammation/complications
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic/complications
  • Prevalence
  • Risk Factors
  • Sex Characteristics

Cite this

@article{ffaee9eedd384d54a6dbf5a9c6b1e752,
title = "Sex differences in coronary plaque composition evaluated by coronary computed tomography angiography in newly diagnosed Type 2 diabetes: Association with low-grade inflammation",
abstract = "Aim: To determine differences in coronary plaque composition and inflammatory biomarkers between men and women with newly diagnosed Type 2 diabetes without known cardiovascular disease. Methods: A total of 88 people with newly diagnosed (<1 year) Type 2 diabetes underwent contrast-enhanced coronary computed tomography angiography. Advanced coronary plaque analysis was performed using semi-automated software. Plasma concentrations of inflammatory biomarkers were determined. Results: There were no significant differences between men (n=60) and women (n=28) regarding age or cardiovascular risk factors (all P>0.05). The median (quartiles) serum levels of fibrinogen [10.9 (9.8-12.6) μmol/l vs 9.7 (8.8-10.9) μmol/l], fibrin d-dimer [0.3 (0.2-0.4) mg/l vs 0.27 (0.2-0.4) mg/l] and C-reactive protein [3.1 (1.1-5.2) mg/l vs (0.8-2.6) 1.6 mg/l] were significantly higher in women (all P<0.05). Overall, men more often had multi-vessel involvement [28 men (47{\%}) vs 4 women (14{\%})], and higher total plaque burden [median (quartiles) 11.6 (2.3-36.0){\%} vs 2.0 (0.4-5.4){\%}; both P<0.05]. The median (quartiles) total plaque volume [269.9 (62.6-641.9) mm3 vs 61.1 (7.6-239.9) mm3] and absolute calcified plaque volume [33.5 (8.3-148.3) mm3 vs 4.7 (0.9-17.3) mm3] were higher in men (both P<0.05). Women had a lower relative proportion of the calcified plaque component [median (quartiles) 7.8 (4.7-15.4){\%} vs 23.7 (8.4-31.1){\%}] and a higher relative proportion (median [quartiles]) of the non-low-density non-calfied plaque component [77.6 (66.0-86.0){\%} vs 63.6 (54.0-72.9){\%}; both P<0.05]. Conclusions: 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.",
keywords = "Aged, Computed Tomography Angiography, Coronary Angiography/methods, Coronary Artery Disease/complications, Diabetes Mellitus, Type 2/complications, Diabetic Angiopathies/complications, Female, Humans, Inflammation/complications, Male, Middle Aged, Plaque, Atherosclerotic/complications, Prevalence, Risk Factors, Sex Characteristics",
author = "M. Mrgan and J. Gram and {Hecht Olsen}, M. and D. Dey and {Linde N{\o}rgaard}, B. and J. Gram and {R{\o}nnow Sand}, {N. P.}",
year = "2018",
month = "11",
doi = "10.1111/dme.13768",
language = "English",
volume = "35",
pages = "1588--1595",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Sex differences in coronary plaque composition evaluated by coronary computed tomography angiography in newly diagnosed Type 2 diabetes

T2 - Association with low-grade inflammation

AU - Mrgan, M.

AU - Gram, J.

AU - Hecht Olsen, M.

AU - Dey, D.

AU - Linde Nørgaard, B.

AU - Gram, J.

AU - Rønnow Sand, N. P.

PY - 2018/11

Y1 - 2018/11

N2 - Aim: To determine differences in coronary plaque composition and inflammatory biomarkers between men and women with newly diagnosed Type 2 diabetes without known cardiovascular disease. Methods: A total of 88 people with newly diagnosed (<1 year) Type 2 diabetes underwent contrast-enhanced coronary computed tomography angiography. Advanced coronary plaque analysis was performed using semi-automated software. Plasma concentrations of inflammatory biomarkers were determined. Results: There were no significant differences between men (n=60) and women (n=28) regarding age or cardiovascular risk factors (all P>0.05). The median (quartiles) serum levels of fibrinogen [10.9 (9.8-12.6) μmol/l vs 9.7 (8.8-10.9) μmol/l], fibrin d-dimer [0.3 (0.2-0.4) mg/l vs 0.27 (0.2-0.4) mg/l] and C-reactive protein [3.1 (1.1-5.2) mg/l vs (0.8-2.6) 1.6 mg/l] were significantly higher in women (all P<0.05). Overall, men more often had multi-vessel involvement [28 men (47%) vs 4 women (14%)], and higher total plaque burden [median (quartiles) 11.6 (2.3-36.0)% vs 2.0 (0.4-5.4)%; both P<0.05]. The median (quartiles) total plaque volume [269.9 (62.6-641.9) mm3 vs 61.1 (7.6-239.9) mm3] and absolute calcified plaque volume [33.5 (8.3-148.3) mm3 vs 4.7 (0.9-17.3) mm3] were higher in men (both P<0.05). Women had a lower relative proportion of the calcified plaque component [median (quartiles) 7.8 (4.7-15.4)% vs 23.7 (8.4-31.1)%] and a higher relative proportion (median [quartiles]) of the non-low-density non-calfied plaque component [77.6 (66.0-86.0)% vs 63.6 (54.0-72.9)%; both P<0.05]. Conclusions: 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.

AB - Aim: To determine differences in coronary plaque composition and inflammatory biomarkers between men and women with newly diagnosed Type 2 diabetes without known cardiovascular disease. Methods: A total of 88 people with newly diagnosed (<1 year) Type 2 diabetes underwent contrast-enhanced coronary computed tomography angiography. Advanced coronary plaque analysis was performed using semi-automated software. Plasma concentrations of inflammatory biomarkers were determined. Results: There were no significant differences between men (n=60) and women (n=28) regarding age or cardiovascular risk factors (all P>0.05). The median (quartiles) serum levels of fibrinogen [10.9 (9.8-12.6) μmol/l vs 9.7 (8.8-10.9) μmol/l], fibrin d-dimer [0.3 (0.2-0.4) mg/l vs 0.27 (0.2-0.4) mg/l] and C-reactive protein [3.1 (1.1-5.2) mg/l vs (0.8-2.6) 1.6 mg/l] were significantly higher in women (all P<0.05). Overall, men more often had multi-vessel involvement [28 men (47%) vs 4 women (14%)], and higher total plaque burden [median (quartiles) 11.6 (2.3-36.0)% vs 2.0 (0.4-5.4)%; both P<0.05]. The median (quartiles) total plaque volume [269.9 (62.6-641.9) mm3 vs 61.1 (7.6-239.9) mm3] and absolute calcified plaque volume [33.5 (8.3-148.3) mm3 vs 4.7 (0.9-17.3) mm3] were higher in men (both P<0.05). Women had a lower relative proportion of the calcified plaque component [median (quartiles) 7.8 (4.7-15.4)% vs 23.7 (8.4-31.1)%] and a higher relative proportion (median [quartiles]) of the non-low-density non-calfied plaque component [77.6 (66.0-86.0)% vs 63.6 (54.0-72.9)%; both P<0.05]. Conclusions: 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.

KW - Aged

KW - Computed Tomography Angiography

KW - Coronary Angiography/methods

KW - Coronary Artery Disease/complications

KW - Diabetes Mellitus, Type 2/complications

KW - Diabetic Angiopathies/complications

KW - Female

KW - Humans

KW - Inflammation/complications

KW - Male

KW - Middle Aged

KW - Plaque, Atherosclerotic/complications

KW - Prevalence

KW - Risk Factors

KW - Sex Characteristics

U2 - 10.1111/dme.13768

DO - 10.1111/dme.13768

M3 - Journal article

C2 - 29931809

AN - SCOPUS:85050689328

VL - 35

SP - 1588

EP - 1595

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 11

ER -