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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.

Authors :
Reijrink M
Sluiter JKE
Te Velde-Keyzer CA
de Borst MH
van Praagh GD
Greuter MJW
Luurtsema G
Boersma HH
Pol RA
Hillebrands JL
van Dijk PR
Hoogenberg K
Mulder DJ
Slart RHJA
Source :
Atherosclerosis [Atherosclerosis] 2024 Jul; Vol. 394, pp. 117199. Date of Electronic Publication: 2023 Jul 29.
Publication Year :
2024

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.)

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