Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease

Aim: The aim of this study was to evaluate the differences in plaque composition and burden between normal glycemic status (NGS) and dysglycemia expressed as impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). Methods: Clinically indicated coronary computed tomography angiography w...

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Main Authors: Thomas R. Andersen, Katrine S. Overgaard, Laurits Juhl Heinsen, Roda Abdulkadir Mohamed, Helle Precht, Jess Lambrechtsen, Søren Auscher, Kenneth Egstrup
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/1/28
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author Thomas R. Andersen
Katrine S. Overgaard
Laurits Juhl Heinsen
Roda Abdulkadir Mohamed
Helle Precht
Jess Lambrechtsen
Søren Auscher
Kenneth Egstrup
author_facet Thomas R. Andersen
Katrine S. Overgaard
Laurits Juhl Heinsen
Roda Abdulkadir Mohamed
Helle Precht
Jess Lambrechtsen
Søren Auscher
Kenneth Egstrup
author_sort Thomas R. Andersen
collection DOAJ
description Aim: The aim of this study was to evaluate the differences in plaque composition and burden between normal glycemic status (NGS) and dysglycemia expressed as impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). Methods: Clinically indicated coronary computed tomography angiography was used to evaluate patients with suspected coronary artery disease (CAD). An oral glucose tolerance test was performed to assess glycemic status. Patients were stratified as NGS, IGT, and T2DM. Plaque volumes were quantified using validated software, with further compositional measurements of low-attenuation, non-calcified, and calcified plaque burden. Results: Of 355 patients with suspected CAD, 220 had NGS, 92 were diagnosed with IGT, and 43 with known T2DM. Low-attenuation plaque volume was significantly higher in IGT (209 mm<sup>3</sup>, <i>p</i> < 0.02) and T2DM (243 mm<sup>3</sup>, <i>p</i> = 0.005) compared with NGS (166 mm<sup>3</sup>). Total plaque burden was similar between all groups, but a significantly greater low-attenuation plaque burden was seen in IGT (<i>p</i> = 0.03) and T2DM (<i>p</i> = 0.02) compared with NGS. The multivariate linear regression model adjusted for clinical risk factors showed that patients with IGT had a greater low-attenuation plaque burden compared with those with NGS (<i>p</i> = 0.03). Interestingly, no significant differences in plaque burdens were observed between those with IGT and T2DM in both univariate and multivariate analyses. Conclusions: Dysglycemia, including impaired glucose tolerance and type 2 diabetes mellitus, was associated with increased low-attenuation plaque burden compared with normal glycemic status. Patients with IGT demonstrated plaque burden similar to patients with known T2DM, underscoring the need for early metabolic intervention.
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spelling doaj-art-1786a9e5febd4b0591404b66397581232025-01-24T13:23:46ZengMDPI AGBiomedicines2227-90592024-12-011312810.3390/biomedicines13010028Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery DiseaseThomas R. Andersen0Katrine S. Overgaard1Laurits Juhl Heinsen2Roda Abdulkadir Mohamed3Helle Precht4Jess Lambrechtsen5Søren Auscher6Kenneth Egstrup7Cardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkCardiovascular Research Unit, Odense University Hospital Svendborg, 5700 Svendborg, DenmarkAim: The aim of this study was to evaluate the differences in plaque composition and burden between normal glycemic status (NGS) and dysglycemia expressed as impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). Methods: Clinically indicated coronary computed tomography angiography was used to evaluate patients with suspected coronary artery disease (CAD). An oral glucose tolerance test was performed to assess glycemic status. Patients were stratified as NGS, IGT, and T2DM. Plaque volumes were quantified using validated software, with further compositional measurements of low-attenuation, non-calcified, and calcified plaque burden. Results: Of 355 patients with suspected CAD, 220 had NGS, 92 were diagnosed with IGT, and 43 with known T2DM. Low-attenuation plaque volume was significantly higher in IGT (209 mm<sup>3</sup>, <i>p</i> < 0.02) and T2DM (243 mm<sup>3</sup>, <i>p</i> = 0.005) compared with NGS (166 mm<sup>3</sup>). Total plaque burden was similar between all groups, but a significantly greater low-attenuation plaque burden was seen in IGT (<i>p</i> = 0.03) and T2DM (<i>p</i> = 0.02) compared with NGS. The multivariate linear regression model adjusted for clinical risk factors showed that patients with IGT had a greater low-attenuation plaque burden compared with those with NGS (<i>p</i> = 0.03). Interestingly, no significant differences in plaque burdens were observed between those with IGT and T2DM in both univariate and multivariate analyses. Conclusions: Dysglycemia, including impaired glucose tolerance and type 2 diabetes mellitus, was associated with increased low-attenuation plaque burden compared with normal glycemic status. Patients with IGT demonstrated plaque burden similar to patients with known T2DM, underscoring the need for early metabolic intervention.https://www.mdpi.com/2227-9059/13/1/28computed coronary tomography angiographylow-attenuation plaquedysglycemiaimpaired glucose tolerancetype 2 diabetes mellitusplaque burden
spellingShingle Thomas R. Andersen
Katrine S. Overgaard
Laurits Juhl Heinsen
Roda Abdulkadir Mohamed
Helle Precht
Jess Lambrechtsen
Søren Auscher
Kenneth Egstrup
Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease
Biomedicines
computed coronary tomography angiography
low-attenuation plaque
dysglycemia
impaired glucose tolerance
type 2 diabetes mellitus
plaque burden
title Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease
title_full Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease
title_fullStr Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease
title_full_unstemmed Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease
title_short Association of Low-Attenuation Plaque with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus in Patients with Suspected Coronary Artery Disease
title_sort association of low attenuation plaque with impaired glucose tolerance and type 2 diabetes mellitus in patients with suspected coronary artery disease
topic computed coronary tomography angiography
low-attenuation plaque
dysglycemia
impaired glucose tolerance
type 2 diabetes mellitus
plaque burden
url https://www.mdpi.com/2227-9059/13/1/28
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