Sex differences in cardiovascular risk factors before and after the development of type 2 diabetes and risk for incident cardiovascular disease. (August 2020)

• Record Type: Journal Article
• Authors: Bancks, Michael P.; Akhabue, Ehimare; Rana, Jamal S.; Reis, Jared P.; Schreiner, Pamela J.; Yano, Yuichiro; Lewis, Cora E.
• Is Part Of: Diabetes research and clinical practice. Volume 166(2020)
• Publication Date: 2020-08
• Subjects: Sex differences -- Diabetes -- Cardiovascular disease -- Cardiovascular risk factors -- Young adulthood -- Incidence; BHS Bogalusa Heart Study -- CARDIA Coronary Artery Risk Development in Young Adults -- CL confidence limits -- CVD cardiovascular disease -- DBP diastolic blood pressure -- FG fasting glucose -- HbA1c glycated hemoglobin -- HDL high-density lipoprotein -- HR hazard ratio -- LDL low-density lipoprotein -- MI myocardial infarction -- SBP systolic blood pressure -- T2D type 2 diabetes; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108334
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Before diabetes, CVD risk factor changes do not differ by sex in young adults. After diabetes, CVD risk factors worsen more rapidly for women than men. Diabetes was not a stronger risk factor for incident CVD for women than men. Women had lower absolute and relative risks for incident CVD by mid-life than men. Abstract: Aims: To assess sex differences in cardiovascular (CVD) risk factor changes before and after the development of type 2 diabetes, and, the association between incident diabetes with incident CVD in mid-life. Methods: We included 4893 Coronary Artery Risk Development in Young Adults Study participants, age 18–30 years at enrollment (1985–86). We ascertained incident diabetes and assessed sex differences in annual change in body mass index, blood pressure, and lipids before and after the ascertainment of diabetes using piecewise linear regression. We examined sex differences in the association between incident diabetes with incident CVD over 31 years of median follow-up. Results: Progression in most CVD risk factors did not differ by sex before diabetes. Women had better CVD profiles at the time of diabetes compared to men, and after diabetes, women had worse annual changes in blood pressure and lipids. Incident diabetes was associated with a higher hazard for incident CVD (Hazard Ratio [HR]: 1.45, 95% confidence limits: 1.07, 1.96) and we did not observe effect modification by sex (p for interaction = 0.8). Conclusions: CVD risk factors worsened more rapidly after the development of type 2 diabetes for women than men. However, diabetes was not a stronger risk factor for incident CVD for women than men.