Key result
Overweight patients with type 2 diabetes had significantly reduced stress myocardial blood flow (1.60 mL/g/min) compared to healthy overweight controls (2.08 mL/g/min; p≤0.0001).
Why the study?
It was unclear whether diabetes affects coronary microvascular function in individuals with normal body weight.
Does type 2 diabetes affect coronary microvascular function in individuals with normal body weight compared to overweight individuals and healthy volunteers?
Cross-Sectional (n=75)
Does type 2 diabetes affect coronary microvascular function in individuals with normal body weight compared to overweight individuals and healthy volunteers?
Absolute Event Rate: 1.6% vs 2.08%
p-value: p=≤ 0.0001
Lean patients with type 2 diabetes do not exhibit impaired coronary microvascular function despite increased visceral adiposity, whereas overweight patients with T2D show significant reductions in stress myocardial blood flow.
Lean T2D patients show preserved stress MBF; leaves open whether visceral adiposity alone drives microvascular impairment in diabetes.
Objective This study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight. Methods Seventy‐five participants (30 patients with type 2 diabetes [T2D] who were overweight [O‐T2D], 15 patients with T2D who were lean [LnT2D], 15 healthy volunteers who were lean [LnHV], and 15 healthy volunteers who were overweight [O‐HV]) without established cardiovascular disease were recruited. Participants underwent magnetic resonance imaging for assessment of subcutaneous, epicardial, and visceral adipose tissue areas, adenosine stress myocardial blood flow (MBF), and cardiac structure and function. Results Stress MBF was reduced only in the O‐T2D group (mean [SD], LnHV = 2.07 [0.47] mL/g/min, O‐HV = 2.08 [0.42] mL/g/min, LnT2D = 2.16 [0.36] mL/g/min, O‐T2D = 1.60 [0.28] mL/g/min; p ≤ 0.0001). Accumulation of visceral fat was evident in the LnT2D group at similar levels to the O‐HV group (LnHV = 127 [53] cm2, O‐HV = 181 [60] cm2, LnT2D = 182 [99] cm2, O‐T2D = 288 [72] cm2; p < 0.0001). Only the O‐T2D group showed reductions in left ventricular ejection fraction (LnHV = 63% [4%], O‐HV = 63% [4%], LnT2D = 60% [5%], O‐T2D = 58% [6%]; p = 0.0008) and global longitudinal strain (LnHV = −15.1% [3.1%], O‐HV= −15.2% [3.7%], LnT2D = −13.4% [2.7%], O‐T2D = −11.1% [2.8%]; p = 0.002) compared with both control groups. Conclusions Patients with T2D and normal body weight do not show alterations in global stress MBF, but they do show significant increases in visceral adiposity. Patients with T2D who were overweight and had no prior cardiovascular disease showed an increase in visceral adiposity and significant reductions in stress MBF.
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Chowdhary et al. (2022) conducted a cross-sectional in Type 2 diabetes (n=75). Type 2 diabetes and overweight status vs. Healthy volunteers and lean patients with type 2 diabetes was evaluated on Adenosine stress myocardial blood flow (MBF) (p=≤ 0.0001). Overweight patients with type 2 diabetes had significantly reduced stress myocardial blood flow (1.60 mL/g/min) compared to healthy overweight controls (2.08 mL/g/min; p≤0.0001).
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