Succurro Elena, Vizza Patrizia, Cicone Francesco, Cassano Velia, Massimino Mattia, Giofrè Federica, Fiorentino Teresa Vanessa, Perticone Maria, Sciacqua Angela, Guzzi Pietro Hiram, Veltri Pierangelo, Andreozzi Francesco, Cascini Giuseppe Lucio, Sesti Giorgio
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Graecia of Catanzaro, Catanzaro, Italy.
Cardiovasc Diabetol. 2024 Apr 26;23(1):144. doi: 10.1186/s12933-024-02246-7.
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.
We aimed to evaluate sex-related differences in myocardial glucose metabolic rate (MRGlu), assessed using dynamic PET with F-FDG combined with euglycemic-hyperinsulinemic clamp, in subjects with normal glucose tolerance (NGT; n = 20), prediabetes (n = 11), and T2DM (n = 26).
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% lower myocardial MRGlu value (P = 0.04) and women with T2DM a 74% lower value (P = 0.006), respectively. Conversely, as compared with men with NGT, men with T2DM exhibited a 40% lower myocardial MRGlu value (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.
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.
有证据表明，2型糖尿病（T2DM）女性患心血管疾病（CVD）的额外风险高于T2DM男性。患有T2DM或糖尿病前期的受试者表现出心肌胰岛素抵抗，但糖尿病和糖尿病前期受试者是否存在心肌胰岛素抵抗的性别差异仍未确定。
我们旨在评估葡萄糖耐量正常（NGT；n = 20）、糖尿病前期（n = 11）和T2DM（n = 26）受试者中，使用F-FDG动态PET结合正常血糖-高胰岛素钳夹技术评估的心肌葡萄糖代谢率（MRGlu）的性别差异。
与NGT受试者相比，糖尿病前期或T2DM女性的心肌MRGlu相对差异大于糖尿病前期或T2DM男性。与NGT女性相比，糖尿病前期女性的心肌MRGlu值经年龄调整后降低了35%（P = 0.04），T2DM女性降低了74%（P = 0.006）。相反，与NGT男性相比，T2DM男性的心肌MRGlu值降低了40%（P = 0.004），而NGT男性和糖尿病前期男性之间未观察到显著差异。心肌MRGlu的性别与葡萄糖耐量之间的交互作用统计检验（P < 0.0001）具有显著性，表明存在性别特异性关联。
我们的数据表明，与男性相比，女性葡萄糖稳态的恶化与心肌葡萄糖代谢的更大损害有关。性别特异性心肌胰岛素抵抗可能是T2DM对女性心血管疾病额外风险的影响大于男性的一个重要因素。
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