Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189, Rome, Italy.
Cardiovasc Diabetol. 2021 Mar 6;20(1):60. doi: 10.1186/s12933-021-01248-z.
Women with type 2 diabetes (T2DM) have a higher excess risk for cardiovascular disease (CVD) than their male counterparts. However, whether the risk for CVD is higher in prediabetic women than men is still debated. We aimed to determine whether sex-related differences exist in left ventricular mass index (LVMI), and myocardial mechano-energetic efficiency (MEEi) in with normal glucose tolerant (NGT), pre-diabetic and newly diagnosed type 2 diabetic subjects.
Sex-related differences in LVMI and myocardial MEEi, assessed by validated echocardiography-derived measures, were examined among 1562 adults with NGT, prediabetes, and newly diagnosed T2DM, defined according to fasting glucose, 2-h post-load glucose, or HbA1c.
Worsening of glucose tolerance in both men and women was associated with an increase in age-adjusted LVMI and myocardial MEEi. Women with newly diagnosed T2DM exhibited greater relative differences in LVMI and myocardial MEEi than diabetic men when compared with their NGT counterparts. Prediabetic women exhibited greater relative differences in myocardial MEEi, but not in LVMI, than prediabetic men when compared with their NGT counterparts. The statistical test for interaction between sex and glucose tolerance on both LVMI (P < 0.0001), and myocardial MEEi (P < 0.0001) was significant suggesting a sex-specific association.
Left ventricle is subject to maladaptive changes with worsening of glucose tolerance, especially in women with newly diagnosed T2DM. The sex-specific increase in LVM and decrease in MEEi, both being predictors of CVD, may have a role in explaining the stronger impact of T2DM on the excess risk of CVD in women than in men.
相较于男性，患有 2 型糖尿病（T2DM）的女性患心血管疾病（CVD）的风险更高。然而，糖尿病前期女性的 CVD 风险是否高于男性仍存在争议。我们旨在确定在糖耐量正常（NGT）、糖尿病前期和新诊断的 2 型糖尿病患者中，性别相关差异是否存在于左心室质量指数（LVMI）和心肌机械-能量效率（MEEi）中。
通过验证的超声心动图衍生指标评估了 1562 名 NGT、糖尿病前期和新诊断的 T2DM 成人的 LVMI 和心肌 MEEi 中的性别相关差异，这些患者是根据空腹血糖、2 小时负荷后血糖或糖化血红蛋白来定义的。
无论男女，葡萄糖耐量恶化均与年龄校正的 LVMI 和心肌 MEEi 增加相关。与男性糖尿病患者相比，新诊断的 T2DM 女性的 LVMI 和心肌 MEEi 相对差异更大。与 NGT 女性相比，糖尿病前期女性的心肌 MEEi 相对差异更大，但 LVMI 无差异。LVMI（P<0.0001）和心肌 MEEi（P<0.0001）的性别与葡萄糖耐量之间的交互统计检验具有统计学意义，表明存在性别特异性关联。
随着葡萄糖耐量恶化，左心室会发生适应性变化，尤其是在新诊断的 T2DM 女性中。LVMI 增加和 MEEi 降低（两者均为 CVD 的预测指标），可能在解释 T2DM 对女性 CVD 风险的影响强于男性方面发挥作用。
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