Endocrine Abstracts

JOINT2018

Background: According to the World Health Statistics 2024, diabetes mellitus (DM) remains a major metabolic risk factor for non-communicable diseases. Early screening and timely assessment of prognostic markers such as carotid artery stiffness (CAS), pulse wave velocity (PWV) in carotid and femoral arteries, carotid intima-media thickness (CIMT) are important for prevention of cardiometabolic complications. The use of phenotypic age (PA) is gaining popularity in clinical practice as it more accurately predicts age-associated changes than chronological age (CA).

Aim: The aim of our study was to evaluate the association of PA with cardiovascular risk factors compared with CA among patients with newly diagnosed type 2 diabetes mellitus (DM-2).

Methods: 98 patients with type 2 DM (mean age 50.9 [47.5; 55.1] years) were compared with 20 age-reciprocal control patients (mean age 51.0 [48.4; 55.2] years) without DM-2. All patients were divided into two groups: aged <50 years and ≥50 years, based on CA (n = 24 vs n = 74, respectively) and PA (n = 54 vs n = 44), according to the method described by Levine et al., 2018. Anthropometrics, carbohydrate, lipid profiles, glomerular filtration rate (GFR), CAS, PWV and CIMT were assessed in all participants. The Mann-Whitney test was used to assess intergroup quantitative differences.

Results: There were significant differences in body mass index, carbohydrate and lipid profiles (P <0.01), PA (P = 0.001), CAS (P = 0.018), PWV (P = 0.0001) and CIMT (P = 0.0001) between patients with newly diagnosed DM-2 and controls. Among all subjects with newly diagnosed DM-2, both CA and PA were associated with HOMA-IR (r = 0.384, P = 0.0001 and r = 0.760, P = 0.003), TC (r = 0.620, P = 0.0001 and r = 0.825, P = 0.0001), HDL-C (r = 0.258, P=0.003 and r = 0.562, P = 0.001), LDL-C (r = 0.612, P = 0.0001 and r = 0.814, P = 0.0001), GFR (r = 0.523, P = 0.001 and r = 0.869, P = 0.001), CIMT (r 0.570, P = 0.0001 and r = 0.836, P = 0.0001). Meanwhile, CAS (P = 0.027), PWV (P = 0.034) and CIMT (P = 0.0001) were significantly higher in patients with newly diagnosed DM-2, in the PA subgroup ≥50 years. Glycated haemoglobin levels in the subgroup with PA <50 years were significantly higher than the subgroup of CA <50 years (P = 0.001), as was the HOMA-IR score (P=0.01).

Conclusions: Assessment of PA compared to СA in patients with DM-2 allows earlier diagnosis not only of disorders in carbohydrate metabolism, but also allows timely detection of the consequences of cardiometabolic changes based on CAC, PWV, CIMT than an increase in СA, which means preventing the addition of new patients with high and very high cardiovascular risk.