What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 Diabetes and obesity (n=37). Intervention: Female sex vs. Male sex. Primary outcome: Cardiac remodeling parameters (Z-scores).

What does this research mean for the field?

In young adults with type 2 diabetes and obesity, left ventricular mass indexed to body surface area reveals early subclinical structural remodeling that precedes overt functional impairment. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to explore sex differences in cardiac remodeling among young adults with type 2 diabetes and obesity.

June 7, 2026

1419-P: Sex Differences in Cardiac Remodeling in Young Adults with Type 2 Diabetes and Obesity

Key Result

Female and male young adults with obesity demonstrated large deviations in LV mass indexed to body surface area (Z=-1.62 and Z=-2.03), indicating early subclinical structural remodeling.

Key Points

The study aims to explore sex differences in cardiac remodeling among young adults with type 2 diabetes and obesity.
Young women (n=14) and men (n=23) with obesity and type 2 diabetes were recruited.
Participants underwent cardiac MRI to evaluate left and right ventricular function and myocardial tissue characteristics.
Z-scores were computed using sex-specific reference values from SCMR to identify significant differences.
Females showed deviations in left ventricular (LV) end-systolic volume (Z=1.27) and ejection fraction (Z=-1.00).
Both sexes exhibited significant deviations in indexed LV mass (females: Z=-1.62, males: Z=-2.03).
Sex differences were noted in right ventricular parameters, though within normal ranges.

Study Design

Type

Cross-Sectional (n=37)

Structured PICO

Are there sex differences in early cardiac remodeling assessed by CMR in young adults with obesity and Type 2 Diabetes?

Population

37 young adults (14 women, 23 men) with obesity and a high prevalence of Type 2 Diabetes undergoing comprehensive cardiac MRI.

Exposure

Cardiac MRI (Philips 3T) assessment

Comparator

Sex differences (females vs. males)

Outcome

Left and right ventricular size and global function, LV global strain, aortic flow, and myocardial tissue characterization (native T1 and T2* mapping)surrogate

Young adults with obesity and Type 2 Diabetes exhibit early subclinical structural cardiac remodeling, particularly in LV mass indexed to body surface area, which may precede overt functional impairment.

Abstract

Introduction and Objective: Young-onset Type 2 Diabetes (T2D) and obesity increase cardiovascular risk, yet sex differences in early cardiac remodeling remain poorly defined. We assessed sex differences using a comprehensive cardiac MRI (CMR) assessment. Methods: Young women (n=14, 27±8 years, 71% T2D) and men (n=23, 23±5 years, 70% T2D) with obesity were recruited. Participants underwent cardiac MRI (Philips 3T) to assess left (LV) and right (RV) ventricular size and global function, LV global strain, aortic flow, and myocardial tissue characterization using native T1 and T2* mapping. Z-scores were calculated using sex-specific reference values from the Society for Cardiovascular Magnetic Resonance (SCMR) normal values consensus (2025 update). P-values indicate observed significant differences between females and males in this study. Values are highlighted in bold when |Z| ≥ 1 and P 0.05. Results: Females demonstrated modest deviations in LV end-systolic volume (Z=1.27) and ejection fraction (Z=-1.00). Large deviations in LV mass indexed to body surface area were observed in both females (Z=-1.62) and males (Z=-2.03). Significant sex differences were observed in RV parameters, although these measures remained within normal reference ranges. Conclusion: LV mass indexed to body surface area demonstrates early subclinical structural remodeling in young adults with T2D and obesity, which may precede overt functional impairment and contribute to future cardiovascular risk. Disclosure S. Park: None. Y. Choi: None. S. Ramesh: None. J. Kendrick: Advisory Panel; Current; Fresenius Medical Care. Research Support; Current; Eli Lilly and Company, Bayer AG, Novo Nordisk. J. Reusch: Advisory Panel; Current; Medtronic. K. Tuttle: Consultant; Ended; Alnylam Pharmaceuticals, Inc. Consultant; Current; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, GlaxoSmithKline plc., Novo Nordisk, Lilly, ProKidney. Consultant; Ended; Roche Diabetes Care. Research Support; Ended; Travere. J. Romanowicz: None. L. Pyle: None. K. Tommerdahl: Advisory Panel; Current; Sanofi. L.M. Laffel: Other - Travel support for scientific presentations; Ended; Boehringer Ingelheim International GmbH. Other - DSMB Chair; Ended; Janssen Pharmaceuticals, Inc. Consultant; Current; Dexcom, Inc. Advisory Panel; Current; Medtronic, Sequel, Tandem Diabetes Care, Inc. Consultant; Current; Roche Diabetes Care, Sinocare. Advisory Panel; Ended; Sanofi. Advisory Panel; Current; MannKind Corporation. K. Bornfeldt: Advisory Panel; Current; ESPERION Therapeutics, Inc. J. Kanter: None. M.L. Granda: None. B. Ariens: None. E.K. Englund: None. A.J. Kula: None. J. Snell-Bergeon: None. A. Caldwell-McGee: None. C.L. Birznieks: None. T.J. Dobbs: None. K.J. Nadeau: None. L. Browne: None. A. Barker: None. P. Bjornstad: Consultant; Current; Bayer AG, Boehringer Ingelheim International GmbH, Lilly, Novo Nordisk. Funding American Diabetes Association (4-24-PDF-51)

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