Higher Exposure to CVD Risk Factors in Women vs Men Who Have Diabetes

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Compared with men, women who have diabetes experience greater changes in the cumulative burden of cardiovascular risk factors from young to middle-age adulthood.

Compared with men, women in whom diabetes develops experience greater changes in the cumulative burden of cardiovascular risk factors from young to middle-age adulthood, which may contribute to a higher risk for cardiovascular disease (CVD) events, report the findings of a study published in Diabetes Care.

Research shows that women with diabetes are at markedly higher risk for CVD events compared with women without diabetes, but for men the risk is only moderately increased. The reasons for the more pronounced effect of diabetes on CVD risk in women has not been well defined. In the current study, data from the long-running Bogalusa Heart Study were used to compare cardiovascular risk factors from childhood through midlife as well as rates of change in risk factor exposure since childhood in individuals with and without diabetes. The cohort included 1530 participants who were followed for a mean of 33.1 years and who had been examined at least 4 times since childhood (mean age at first examination, 9.4 years).

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Majorcardiovascular risk factors measured from childhood to adulthood did not differ significantly between individuals in whom diabetes developed later in adulthood and participants in whom diabetes did not develop. However, during the transition from nor moglycemia to diabetes, women experienced greater adverse changes in several risk factor markers, including total cholesterol, low-density lipoprotein cholesterol, and fasting plasma glucose levels. These changes were observed as early as age 23.5 years and persisted across adulthood to the age of diabetes diagnosis. There was strong statistical evidence for differences between sexes in the association between subsequent development of diabetes and total cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose,and the prevalence of metabolic syndrome (P<.05 for effect modification of sex on the relationship among these cardiovascular risk factors and diabetes status).

“Preventive strategies for cardiovascular risk and diabetes should include a focus on early life and young adulthood when these changes can initially be detected,” wrote the researchers.

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Du T, Fernandez C,Barshop R, et al. Sex differences in cardiovascularrisk profile from childhood to midlife between individuals who did and did not developdiabetes at follow-up: the Bogalusa Heart Study [published onlineJanuary 28, 2019]. Diabetes Care. doi:10.2337/dc18-2029