Sex-specific differences in myocardial glucose metabolic rate in non-diabetic, pre-diabetic and type 2 diabetic subjects

• Published in: Cardiovascular diabetology Vol. 23; no. 1; p. 144
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: England BioMed Central 26.04.2024; BMC
• Subjects: Adult; Aged; Biomarkers - blood; Blood Glucose - metabolism; Cardiac 18F-FDG PET; Cardiac stress tests; Cardiovascular disease; Cardiovascular diseases; Case-Control Studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - metabolism; Drug dosages; Electrocardiography; Energy Metabolism; Female; Fluorodeoxyglucose F18; Gender differences; Glucose; Glucose Clamp Technique; Glucose metabolism; Glucose tolerance; Health risks; Heart; Homeostasis; Humans; Insulin - blood; Insulin Resistance; Male; Metabolic disorders; Metabolic rate; Middle Aged; Myocardial glucose metabolism; Myocardium - metabolism; Plasma; Positron emission tomography; Prediabetes; Prediabetic State - diagnosis; Prediabetic State - epidemiology; Prediabetic State - metabolism; Radiopharmaceuticals; Sex; Sex differences; Sex Factors; Triglycerides; Type 2 diabetes; Womens health; Type 2 diabetes; Cardiovascular disease; Cardiac 18F-FDG PET; Sex-differences; Prediabetes; Myocardial glucose metabolism
• ISSN: 1475-2840; 1475-2840
• 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.