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Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals-a Swedish population-based study
Department of Health, Medicine and Caring Sciences, Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, SE, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.ORCID iD: 0000-0001-9016-1139
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 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.
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2023 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 22, no 1, article id 261Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients 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.

METHODS: The 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.

RESULTS: Study 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.

CONCLUSIONS: In 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.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 22, no 1, article id 261
Keywords [en]
Atherosclerosis, Carotid arteries, Coronary arteries, Coronary computed tomography angiography, Diabetes, Prediabetes
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:umu:diva-215075DOI: 10.1186/s12933-023-01982-6PubMedID: 37759237Scopus ID: 2-s2.0-85172780903OAI: oai:DiVA.org:umu-215075DiVA, id: diva2:1804722
Funder
Swedish Heart Lung Foundation, 2016-0315Knut and Alice Wallenberg Foundation, 2014-0047Swedish Research Council, 822-2013- 2000Vinnova, 2012-04476University of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala UniversitySwedish Research Council, 2018-02527Swedish Heart Lung Foundation, 2021-03459AFA InsuranceEU, European Research Council, ERC-2018-STG801965Swedish Research Council, 2019-01471Swedish Heart Lung Foundation, 20190505Swedish Heart Lung Foundation, 20210184Swedish Research Council, 2021-06432Available from: 2023-10-13 Created: 2023-10-13 Last updated: 2023-10-13Bibliographically approved

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Otten, JuliaHellman, UrbanRenklint, RebeckaSöderberg, Stefan

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