Background
Methods
Study population
Clinical data
Diabetes-related microvascular complications
Biochemistry
Medication
Echocardiography
Global longitudinal strain
Coronary computed tomography angiography
Statistical analysis
Sample size
Linear regression model
Reproducibility
Results
No complications (n = 111) | Any complications (n = 111) | p | |
---|---|---|---|
Clinical | |||
Age (years) | 58 ± 9 | 59 ± 10 | ns |
Men, n (%) | 67 (60) | 84 (76) | 0.01 |
Height (cm) | 174 ± 9 | 176 ± 9 | ns |
Weight (kg) | 90 ± 17 | 93 ± 17 | ns |
BMI (kg/m2) | 30 ± 5 | 30 ± 5 | ns |
Hypertension, n (%) | 64 (58) | 73 (66) | ns |
Hyperlipidaemia, n (%) | 77 (69) | 82 (74) | ns |
Familial predisposition to IHD, n (%) | 16 (14) | 13 (12) | ns |
Smoking exposure (pack-years) [IQR] | 2 [0–25] | 9 [0–29] | ns * |
MAP (mmHg) | 103 ± 10 | 104 ± 10 | ns |
HR (beats/minute) | 67 ± 13 | 71 ± 12 | 0.03 |
Diabetes duration (years) | 11 ± 9 | 16 ± 11 | < 0.001 |
T2DM, n (%) | 88 (79) | 84 (76) | ns |
Biochemistry | |||
Haemoglobin (mmol/L) | 8.6 ± 0.7 | 8.5 ± 0.9 | ns |
eGFR (ml/min/m2) | 75 ± 9 | 72 ± 12 | 0.05 |
HbA1c (mmol/mol) | 59 ± 13 | 63 ± 15 | 0.02 |
LDL (mmol/L) | 2.0 ± 0.8 | 2.2 ± 0.9 | ns |
HDL (mmol/L) | 1.3 ± 0.5 | 1.3 ± 0.4 | ns |
Total cholesterol (mmol/L) | 4.1 ± 1.0 | 4.2 ± 1.1 | ns |
Triglycerides (mmol/L) [IQR] | 1.5 [1.1–2.4] | 1.6 [1.0–2.5] | ns* |
Troponin T (ng/L) [IQR] | 6 [4–9] | 8 [5–12] | 0.01* |
UACR (mg/g) [IQR] | 9 [5–13] | 24 [8–69] | < 0.001* |
Medication | |||
Acetylsalicylic acid, n (%) | 6 (5) | 16 (14) | 0.03 |
Clopidogrel, n (%) | 2 (2) | 6 (5) | ns |
Beta blockers, n (%) | 12 (11) | 10 (9) | ns |
Statins, n (%) | 69 (62) | 77 (69) | ns |
ACE inhibitor/ARB, n (%) | 59 (53) | 69 (62) | ns |
Calcium blockers, n (%) | 19 (17) | 33 (29) | 0.03 |
Diuretics, n (%) | 31 (28) | 37 (33) | ns |
Biguanides, n (%) | 73 (66) | 70 (63) | ns |
SGLT-2 inhibitor, n (%) | 8 (7) | 9 (8) | ns |
DDP-4 inhibitor, n (%) | 16 (14) | 16 (14) | ns |
Sulfonylureas, n (%) | 13 (12) | 19 (17) | ns |
GLP-1 receptor agonists, n (%) | 17 (15) | 22 (20) | ns |
Insulin, n (%) | 52 (47) | 64 (58) | ns |
No microvascular complications (n = 111) | 1 microvascular complication (n = 75) | 2–3 microvascular complications (n = 36) | |
---|---|---|---|
Albuminuria* | |||
No albuminuria | 111 (100) | 47 (63) | 12 (33) |
Microalbuminuria | 0 (0) | 25 (33) | 23 (64) |
Macroalbuminuria | 0 (0) | 3 (4) | 1 (3) |
Nephropathy | |||
No CKD | 7 (6) | 2 (3) | 3 (8) |
Mild CKD | 96 (86) | 65 (87) | 29 (81) |
Moderate CKD (stage IIIa) | 8 (7) | 8 (11) | 4 (11) |
Diabetic retinopathy* | |||
No retinopathy | 104 (94) | 45 (60) | 4 (11) |
Mild NPDR | 0 (0) | 15 (20) | 11 (30.5) |
Moderate NPDR | 0 (0) | 8 (11) | 11 (30.5) |
Severe NPDR | 0 (0) | 2 (3) | 5 (14) |
PDR | 0 (0) | 4 (5) | 5 (14) |
Peripheral neuropathy* | |||
Normal sensitivity | 87 (78) | 48 (64) | 9 (25) |
Reduced sensitivity | 0 (0) | 17 (23) | 24 (67) |
No sensitivity | 0 (0) | 1 (1) | 3 (8) |
Characteristics stratified by diabetes-related microvascular complications
No microvascular complications (n = 111) | 1 microvascular complications (n = 75) | 2–3 microvascular complications (n = 36) | p | |
---|---|---|---|---|
Echocardiography | ||||
LVEF (%) | 56 ± 5 | 54 ± 6 | 55 ± 5 | ns |
GLS (%) | − 16.4 ± 2.5 | − 16.0 ± 2.5 | − 14.9 ± 2.8 | 0.01 |
LAVI (ml/m2) | 22 ± 7 | 23 ± 7 | 21 ± 5 | ns |
LVMI (g/m2) | 71 ± 23 | 77 ± 21 | 71 ± 19 | ns |
e’ (cm/sec) | 0.09 ± 0.02 | 0.09 ± 0.05 | 0.08 ± 0.02 | 0.03 |
IVRT (msec) | 82 ± 20 | 84 ± 17 | 83 ± 17 | ns |
E/e’ | 9.2 ± 2.9 | 9.7 ± 3.1 | 10.0 ± 2.7 | ns |
E/A | 1.1 ± 0.3 | 1.0 ± 0.3 | 0.9 ± 0.3 | ns |
DCT (msec) | 221 ± 56 | 221 ± 53 | 209 ± 44 | ns |
Computed tomography | ||||
CAC [IQR] | 39 [0–239] | 22 [0–180] | 130 [30–720] | ns* |
PB (%) | 20 ± 17 | 22 ± 16 | 27 ± 18 | ns |
PB LAD/LM (%) | 36 ± 11 | 35 ± 9 | 40 ± 11 | ns |
PB RCA (%) | 26 ± 8 | 27 ± 10 | 30 ± 11 | ns |
PB CX (%) | 33 ± 12 | 31 ± 11 | 37 ± 13 | ns |
Coronary artery plaque burden
Linear regression models
Clinical | Univariable | Multivariable* | ||||||
---|---|---|---|---|---|---|---|---|
β | 95% CI | p | β | 95% CI | p | |||
Age (years) | 0.01 | − 0.03 | 0.04 | ns | ||||
Men | 0.60 | − 0.13 | 1.34 | ns | ||||
BMI (kg/m2) | 0.14 | 0.08 | 0.21 | < 0.001 | 0.12 | 0.05 | 0.19 | 0.01 |
MAP (mmHg) | 0.07 | 0.04 | 0.10 | < 0.001 | 0.05 | 0.01 | 0.08 | 0.01 |
Diabetes duration (years) | − 0.03 | − 0.06 | 0.01 | ns | ||||
Microvascular complications | 0.71 | 0.59 | 0.82 | < 0.001 | 0.50 | 0.11 | 0.88 | 0.01 |
Biochemistry | ||||||||
HbA1c (mmol/mol) | 0.01 | − 0.01 | 0.04 | ns | ||||
Medication | ||||||||
Acetylsalicylic acid | 0.06 | − 1.09 | 1.22 | ns | ||||
Calcium blockers | 0.02 | − 0.79 | 0.84 | ns | ||||
Type of diabetes | ||||||||
T2DM | 1.30 | 0.50 | 2.11 | 0.01 | 0.56 | − 0.26 | 1.39 | ns |
Echocardiography | ||||||||
e’ (cm/sec) | − 19.8 | − 30.2 | − 9.42 | < 0.001 | − 12.7 | − 22.8 | − 2.54 | 0.02 |
Computed tomography | ||||||||
PB (%) | 0.01 | − 0.01 | 0.03 | ns |