Diabetes, abdominal adiposity, and atherogenic dyslipoproteinemia in women compared to men

Abstract

Background: Atherogenic risk is generally lower for women than men but similar in persons with diabetes.

Methods and Results: Measures of cardiovascular risk, body composition, and serum hormones from the baseline examinations of the Insulin Resistance Atherosclerosis Study on 524 non-diabetic women, 258 diabetic women, 421 non-diabetic men, and 220 diabetic men were compared to detect greater adverse differences in women than in men. Systolic blood pressure; apolipoprotein B (apoB); total cholesterol; apoB/A1 ratio; non-HDL cholesterol; LDL particle count, small LDL, and IDL by nuclear magnetic resonance (NMR); and c-reactive protein exhibited significant diabetes – gender interaction (p<0.05). ApoB exhibited the most significant interaction (p=0.0005). Age- and ethnicity-adjusted apoB means were lower in non-diabetic women than non-diabetic men (102.4 mg/dl versus 106.8, p<.05) but higher in diabetes (115.7 versus 110.2, p<.01). Plotted against BMI, waist circumference was 6% higher and hip circumference 10 % lower in diabetic than non-diabetic women (both p<0.05) while the circumference measures did not differ conspicuously between diabetic and non-diabetic men.

Conclusions: In diabetic women, an elevated level of atherogenic particles, as manifested by apoB and LDL P, which may result from abdominal adiposity, represents a major treatable cardiovascular risk factor.