Sex differences in myocardial flow reserve among individuals with type 2 diabetes: insights from the DiaHeart study

• DOI: 10.1186/s12933-025-02717-5
• Publication Date: 2025-04-18T12:03:18Z
• Authors: Anne-Cathrine Skr...; Philip Hasbak; Ida K. B. Rasmussen; Martin B. Blond; Victor S. Wasehuus; Mats C. H. Lassen; Morten Lindhardt; Allan Kofoed-Enev...; Urd L. Kielgast; Emilie H. Zobel; Jens P. Goetze; Lene Holmvang; Tor Biering-Sørensen; Peter Rossing; Andreas Kjaer; Rasmus S. Ripa; Tine W. Hansen
• Keywords: Angiology

Type 2 diabetes is a stronger risk factor for cardiovascular disease (CVD) in women compared with men possibly due to higher susceptibility develop myocardial microvascular dysfunction. We investigated sex-dependent effects of factors on blood flow (MBF) and reserve (MFR) individuals type without overt CVD. Cross-sectional analysis prospective study including 901 recruited between 2020 2023. All participants underwent cardiac 82-Rubidium positron emission tomography/computed tomography scan quantify MBF at rest during pharmacologically induced stress, allowing calculation MFR. Linear regression, with/without interaction terms sex, was used test whether sex modified the association MFR/MBF factors. Mean (SD) age 65 (8.9) years, duration 14 (8.4) 266 (29.5%) were women. Women had stress but lower MFR (mean 2.44 (0.67) vs. 2.59 (0.77), p = 0.003) than men. A similar proportion (21.1% 23.7%) an < 2. The decline predicted differed sexes. At 55, mean that 0.29 (95% CI: - 0.44 0.14), by 75, this difference nearly disappeared (- 0.04, 95% 0.19 0.11). However, after adjustment other factors, not statistically significant (p 0.057). No exhibited interactions. In CVD, men, primarily rest, suggesting sex-related differences. While declined both sexes, more pronounced younger diminished over time. These findings underscore need further research into sex-specific thresholds stratification.