Why the study?
It remained unsettled whether sex-related differences in myocardial insulin resistance occur in diabetic and prediabetic subjects, potentially explaining women's higher excess risk of cardiovascular disease.
Deterioration of glucose homeostasis in women is associated with a significantly greater impairment in myocardial glucose metabolism compared to men, potentially explaining the higher excess cardiovascular risk observed in women with type 2 diabetes.
Women with dysglycemia show greater myocardial insulin resistance than men; leaves open whether this drives their excess CVD risk.
Abstract Background Evidence has shown that women with type 2 diabetes (T2DM) have a higher excess risk for cardiovascular disease (CVD) than men with T2DM. Subjects with either T2DM or prediabetes exhibit myocardial insulin resistance, but it is still unsettled whether sex-related differences in myocardial insulin resistance occur in diabetic and prediabetic subjects. Methods we aimed to evaluate sex-related differences in myocardial glucose metabolic rate (MRGlu), assessed using dynamic PET with ¹⁸F-FDG combined with euglycemic-hyperinsulinemic clamp, in subjects with normal glucose tolerance (NGT; n = 20), prediabetes (n = 11), and T2DM (n = 26). Results Women with prediabetes or T2DM exhibited greater relative differences in myocardial MRGlu than men with prediabetes or T2DM when compared with their NGT counterparts. As compared with women with NGT, those with prediabetes exhibited an age-adjusted 35% decrease in myocardial MRGlu (P = 0.04) and women with T2DM a 74% decrease (P = 0.006), respectively. Conversely, as compared with men with NGT, men with T2DM exhibited a 40% reduction in myocardial MRGlu (P = 0.004), while no significant difference was observed between men with NGT and prediabetes. The statistical test for interaction between sex and glucose tolerance on myocardial MRGlu (P < 0.0001) was significant suggesting a sex-specific association. Conclusions Our data suggest that deterioration of glucose homeostasis in women is associated with a greater impairment in myocardial glucose metabolism as compared with men. The sex-specific myocardial insulin resistance could be an important factor responsible for the greater effect of T2DM on the excess risk of cardiovascular disease in women than in men.
No takes yet. Share an insight, caveat, or question.
Succurro et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: