Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals—a Swedish population-based study

Cardiovascular Diabetology

Research

Hanna Markstad¹  Carlo Pirazzi²  Oskar Angerås³  Kerstin Cederlund⁴  Gunnar Engström⁵  Margaretha Persson⁶  Peter Nilsson⁶  Tomas Jernberg⁷  Carl Johan Östgren⁸  Johan Kihlberg⁹  Anders Persson^1,10  Karin Festin^1,11  Emil Hagström^1,12  Stefan K. James^1,12  Tove Fall^1,13  Johan Sundström^1,14  Maria J. Eriksson^1,15  Göran Bergström^1,16  Anders Gummesson^1,17  Annika Rosengren^1,18  Stefan Söderberg^1,19  Urban Hellman^1,19  Julia Otten^1,19  Rebecka Renklint^2,20  David Kylhammar^2,21  Mats Eriksson^2,22 

[1] Center for Medical Imaging and Physiology, Skåne University Hospital and Lund University, Lund, Sweden;Experimental Cardiovascular Research, Clinical Research Center, Clinical Sciences Malmö, Lund University, Malmö, Sweden;Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden;Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden;Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden;Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden;Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden;Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, Sweden;Department of Health, Medicine and Caring Sciences, Centre of Medical Image Science and Visualization (CMIV), Linköping University, 581 83, Linköping, SE, Sweden;Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;Department of Health, Medicine and Caring Sciences, Centre of Medical Image Science and Visualization (CMIV), Linköping University, 581 83, Linköping, SE, Sweden;Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;Department of Health, Medicine and Caring Sciences, Centre of Medical Image Science and Visualization (CMIV), Linköping University, 581 83, Linköping, SE, Sweden;Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden;Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden;Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden;Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden;Department of Medical Sciences, Uppsala University, Uppsala, Sweden;The George Institute for Global Health, University of New South Wales, Sydney, Australia;Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden;Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden;Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden;Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden;Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linköping, Sweden;Medicine Unit Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden;Unit of Endocrinology, Department of Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden;

关键词: Atherosclerosis;    Carotid arteries;    Coronary arteries;    Coronary computed tomography angiography;    Diabetes;    Prediabetes;   

DOI  :  10.1186/s12933-023-01982-6

 received in 2023-03-03, accepted in 2023-09-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPatients with type 2 diabetes have an increased risk of death and cardiovascular events and people with diabetes or prediabetes have been found to have increased atherosclerotic burden in the coronary and carotid arteries. This study will estimate the cross-sectional prevalence of atherosclerosis in the coronary and carotid arteries in individuals with prediabetes and diabetes, compared with normoglycaemic individuals in a large population-based cohort.MethodsThe 30,154 study participants, 50–64 years, were categorized according to their fasting glycaemic status or self-reported data as normoglycaemic, prediabetes, and previously undetected or known diabetes. Prevalence of affected coronary artery segments, severity of stenosis and coronary artery calcium score (CACS) were determined by coronary computed tomography angiography. Total atherosclerotic burden was assessed in the 11 clinically most relevant segments using the Segment Involvement Score and as the presence of any coronary atherosclerosis. The presence of atherosclerotic plaque in the carotid arteries was determined by ultrasound examination.ResultsStudy participants with prediabetes (n = 4804, 16.0%) or diabetes (n = 2282, 7.6%) had greater coronary artery plaque burden, more coronary stenosis and higher CACS than normoglycaemic participants (all, p < 0.01). Among male participants with diabetes 35.3% had CACS ≥ 100 compared to 16.1% among normoglycaemic participants. For women, the corresponding figures were 8.9% vs 6.1%. The prevalence of atherosclerosis in the coronary arteries was higher in participants with previously undetected diabetes than prediabetes, but lower than in patients with known diabetes. The prevalence of any plaque in the carotid arteries was higher in participants with prediabetes or diabetes than in normoglycaemic participants.ConclusionsIn this large population-based cohort of currently asymptomatic people, the atherosclerotic burden in the coronary and carotid arteries increased with increasing degree of dysglycaemia. The finding that the atherosclerotic burden in the coronary arteries in the undetected diabetes category was midway between the prediabetes category and patients with known diabetes may have implications for screening strategies and tailored prevention interventions for people with dysglycaemia in the future.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 1

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