Kidney Week

Abstract: FR-PO335

Influence of Sex and Other Risk Factors, Including Kidney Function, on Myocardial Microvascular Function in Individuals with Type 2 Diabetes Free of Overt Cardiovascular Disease: The DiaHeart Study

Session Information

• Diabetic Kidney Disease: Clinical Modeling, Diagnosis, Education, and More
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Skriver-Møller, Anne-Cathrine, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Anne-Cathrine Skriver-Møller, MD

• Hasbak, Philip, Rigshospitalet, Kobenhavn, Denmark

Philip Hasbak, MD, DrMed

• Rasmussen, Ida Kirstine Bull, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Ida Kirstine Bull Rasmussen, MD, PhD

• Blond, Martin Bæk, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Martin Bæk Blond, MD, PhD

• Wasehuus, Victor, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Victor Wasehuus, MD

• Lassen, Mats H., Gentofte Hospital, Hellerup, Hovedstaden, Denmark

Mats H. Lassen, MD

• Lindhardt, Morten, Zealand University Hospital Holbaek, Holbaek, Denmark

Morten Lindhardt, MD, PhD

• Kofoed-Enevoldsen, Allan, Nykobing F Sygehus, Nykobing, Region Sjælland, Denmark

Allan Kofoed-Enevoldsen, MD, DrMed

• Kielgast, Urd Lynge, Sjaellands Universitetshospital Koge, Koge, Sjælland, Denmark

Urd Lynge Kielgast, MD, PhD

• Zobel, Emilie, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Emilie Zobel

• Holmvang, Lene, Rigshospitalet, Kobenhavn, Denmark

Lene Holmvang, MD, DrMed

• Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Peter Rossing, MD, DrMed

• Biering-Sørensen, Tor, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Tor Biering-Sørensen, MD, MSc, PhD, MPH

• Ripa, Rasmus S., Rigshospitalet, Kobenhavn, Denmark

Rasmus S. Ripa, MD

• Kjaer, Andreas, Rigshospitalet, Kobenhavn, Denmark

Andreas Kjaer, MD, PhD

• Hansen, Tine, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Tine Hansen, MD

Background

Type 2 diabetes (T2D) is a stronger risk factor for cardiovascular disease (CVD) in women than in men and increased with progressive CKD. This might in part be due to women being more susceptible to developing myocardial microvascular dysfunction when compared with men with a similar risk profile. The myocardial flow reserve (MFR) represents the function of the epicardial arteries and the microvasculature and can be measured with a cardiac (Rb⁸²)-PET/CT. We investigated the presence of sex dependent differential effects of CV risk factors, including kidney function, on MFR in people with T2D, free of overt CVD.

Methods

Cross-sectional analysis of a prospective study including 901 T2D individuals. All underwent a cardiac ⁸²Rb-PET/CT for estimation of MFR. Associations between MFR and other risk factors were assessed using linear regression. Differential effects of risk factors by sex were assessed by including an interaction term between one risk factor and sex at a time.

Results

Mean (SD) age was 65 (9) years and 266 (30%) were women. Mean eGFR was 82.1 (21.8) ml/min/1.73² and median (IQR) UACR 7.7 (4.9-19.9) mg/g. MFR was lower in women than in men (2.44 (0.61) vs. 2.59 (0.77), p=0.003). MFR was lower with increasing degree of albuminuria; 2.61 (0.73) for normal, 2.35 (0.67) for moderately and 2.11 (0.72) for severely increased albuminuria, p<0.001.
In a model including age, sex, diabetes duration, BMI, smoking, systolic blood pressure, logUACR, eGFR, HbA1c, and LDL-cholesterol MFR was negatively associated with female sex β -0.19 (95%CI -0.29 to -0.09, p<0.001), age -0.19 (-0.25 to -0.13, p<0.001), and logUACR -0.09 (-0.13 to -0.05, p<0.001). There were no statistically significant interactions with sex for any of the risk factors.

Conclusion

In individuals with T2D free of overt CVD, MFR was lower in women than in men and lower with higher level of albuminuria. Despite lower MFR in women, we found no indications of sex dependent differential effects of any risk factors including UACR and eGFR on MFR.

Funding

• Commercial Support – Novo Nordisk Foundation