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Severely increased albuminuria in patients with type 2 diabetes mellitus is associated with increased subclinical atherosclerosis in femoral arteries with Na [ 18 F]F activity as a proxy - The DETERMINE study.
- Source :
-
Atherosclerosis [Atherosclerosis] 2024 Jul; Vol. 394, pp. 117199. Date of Electronic Publication: 2023 Jul 29. - Publication Year :
- 2024
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Abstract
- Background and Aims: Sodium [ <superscript>18</superscript> F]fluoride (Na [ <superscript>18</superscript> F]F) positron emission tomography imaging allows detailed visualization of early arterial micro-calcifications. This study aims to investigate atherosclerosis manifested by micro-calcification, macro-calcification, and aortic stiffness in patients with type 2 diabetes mellitus (T2DM) with and without albuminuria and severely decreased kidney function.<br />Methods: A cohort was stratified in four groups (N = 10 per group), based on KDIGO categories (G1-5 A1-3). G1-2A1 non-diabetic controls (median [IQR] estimated glomerular filtration rate (eGFR) in mL/min/1.73 m <superscript>2</superscript> 91 [81-104]), G1-2A1 with T2DM (eGFR 87 [84-93], and albumin-creatinin-ratio (ACR) in mg/mmol 0.35 [0.25-0.75]), G1-2A3 with T2DM (eGFR 85 [60-103], and ACR 74 [62-122], and G4A3 with T2DM (eGFR 19 [13-27] and ACR 131 [59-304]).<br />Results: Na [ <superscript>18</superscript> F]F femoral artery grading score differed significantly in the groups with the highest Na [ <superscript>18</superscript> F]F activity in A3 groups with T2DM (G1-2A3 with T2DM 228 [100-446] and G4A3 with T2DM 198 [113-578]) from the lowest groups of the G1-2A1 with T2DM (33 [0-93]) and in G1-2A1 non-diabetic controls (75 [0-200], p = 0.001). Aortic Na [ <superscript>18</superscript> F]F activity and femoral artery computed tomography (CT)-assessed macro-calcification was increased in G4A3 with T2DM compared with G1-2A1 with T2DM (47.5 [33.8-73.8] vs. 17.5 [8.8-27.5] (p = 0.006) and 291 [170-511] vs. 12.2 [1.41-44.3] mg (p = 0.032), respectively). Carotid-femoral pulse wave velocity (PWV)-assessed aortic stiffness was significantly higher in both A3 groups with T2DM compared with G1-2A1 with T2DM (11.15 and 12.35 vs. 8.86 m/s, respectively (p = 0.009)).<br />Conclusions: This study indicates that the presence of severely increased albuminuria in patients with T2DM is cross-sectionally associated with subclinical arterial disease in terms of micro-calcification and aortic stiffness. Additional decrease in kidney function was associated with advanced macro-calcifications.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Female
Male
Middle Aged
Aged
Atherosclerosis diagnostic imaging
Atherosclerosis complications
Vascular Stiffness
Fluorine Radioisotopes
Radiopharmaceuticals
Vascular Calcification diagnostic imaging
Vascular Calcification physiopathology
Diabetic Nephropathies physiopathology
Diabetic Nephropathies diagnostic imaging
Asymptomatic Diseases
Severity of Illness Index
Positron Emission Tomography Computed Tomography
Case-Control Studies
Predictive Value of Tests
Positron-Emission Tomography
Diabetes Mellitus, Type 2 complications
Albuminuria physiopathology
Femoral Artery diagnostic imaging
Femoral Artery physiopathology
Glomerular Filtration Rate
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1484
- Volume :
- 394
- Database :
- MEDLINE
- Journal :
- Atherosclerosis
- Publication Type :
- Academic Journal
- Accession number :
- 37550141
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2023.117199