Sex differences in cardiovascular risk factors among people with type two diabetes
Keywords:Cardiovascular disease, Comparison of CVD risk factors among sexes, Gender sensitive approach, Type 2 diabetes mellitus
Background: Type 2 Diabetes Mellitus is associated with various risk factors, which accelerates the development of cardiovascular disease (CVD). The increased relative risk for CVD due to diabetes is greater in women than in men. Aims and objectives of this study were to study the prevalence of cardiovascular risk factors among type 2 diabetes patients and to assess the sex differences in the prevalence of cardiovascular risk factors among type 2 diabetes patients.
Methods: A cross-sectional study was performed among the 500 adult (>15 years) patients of type 2 diabetes who attended Department of Medicine, SGRDIMSR, Amritsar and were assessed for the presence of various CVD risk factors and the prevalence of these was compared between both sexes.
Results: The most prevalent CVD risk factor among 500 patients of type 2 DM was high HBA1C levels which was present in 67.2% of the study population. It was followed by obesity (which had prevalence of 66.2%), dyslipidaemia (i.e. high triglyceride levels - 64.8% and low HDL levels - 65.6%) and microalbuminuria along with macroalbuminuria (65.4%). Diabetic males had microalbuminuria (along with macroalbuminuria) as the most prevalent CVD risk factor (69.03%), followed by alcohol consumption (63.18%) and abnormal waist circumference (61%). On the other hand, the most prevalent CVD risk factor among female diabetics was high HBA1C (77.4%) followed by obesity (77.0%) and dyslipidaemia-hypertriglyceridemia (75.1%) and low HDL levels (70.5%).
Conclusions: Cardiovascular risk factors were highly prevalent among patients with type 2 diabetes attending department of medicine, SGRDIMSR, Amritsar with different risk profiles among diabetic male and females. A gender-sensitive approach is required in planning interventions (counselling and treatment) to reduce the risk of cardiovascular disease in diabetes.
Chambless L, Keil U, Dobson A, Mähönen M, Kuulasmaa K, Rajakangas AM, Löwel H, et al. Population versus clinical view of case fatality from acute coronary heart disease: Results from the WHO MONICA Project 1985-1990. Circulation. 1997;96(11):3849-59.
Tan ST, Scott W, Panoulas V, Sehmi J, Zhang W, Scott J, et al. Coronary heart disease in Indian Asians. Glob Cardiol Sci Pract. 2014;2014(1):13-23.
World Health Organization. WHO: World Health Survey 2000. CVD Info base. 2000. Available at: http://www.who.int/healthinfo/survey/en/. Accessed 30 January 2016.
Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014 Jan;7(1):45-8.
Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors Harrison’s Principles of Internal Medicine. 19th Ed. United States of America (NY): Mc-Graw Hill Companies; 2015:1578-1586.
Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229-34.
Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ. 2006;332(7533):73-8.
Fox CS, Sullivan LD, Agostino RB, Peter WF. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham Heart Study. Diabetes Care. 2004 Mar;27(3):704-8.
Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab. 2004 Jun;89(6):2583-9.
Nichols GA, Hillier TA, Brown JB. Normal fasting plasma glucose and risk of type 2 diabetes diagnosis. Am J Med. 2008 Jun;121(6):519-24.
Laakso M. Cardiovascular Disease in Type 2 Diabetes from Population to Man to Mechanisms. Diabetes Care. 2010 Feb;33(2):442-9.
Erdogan D, Gullu H, Caliskan M, Ciftci O, Baycan ST, et al. Fasting hypertriglyceridaemia increases carotid intima media thickness and impairs coronary microvascular functions in non‐obese middle aged women but not in men. Heart. 2006;92(2):259-60.
Verhave JC, Hillege HL, de Zeeuw D, de Jong PE. How to measure the prevalence of microalbuminuria in relation to age and gender? Am J Kidney Dis. 2002;40(2):436-7.
Biondi B, Klein I. Hypothyroidism as a risk factor for cardiovascular disease. Endocrine. 2004;24(1):1-13.
Cheung N, Wang JJ, Klein R, Couper DJ, Sharrett AR, Wong TY. Diabetic retinopathy and the risk of coronary heart disease: the atherosclerosis risk in communities study. Diabetes Care. 2007;30(7):1742-6.