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

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) mm 3 vs 61.1 (7.6–239.9) mm 3 ] and absolute calcified plaque volume [33.5 (8.3–148.3) mm 3 vs 4.7 (0.9–17.3) mm 3 ] 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.