Sex differences in endothelial function markers before conversion to pre-diabetes: does the clock start ticking earlier among women? The Western New York Study.
OBJECTIVE
We examined whether biomarkers of endothelial function, fibrinolysis/thrombosis and adiponectin, predict the progression from normal to pre-diabetes more strongly among women than men over 6 years of follow-up from the Western New York Health Study.


METHODS
In 2002-2004, 1,455 participants from the Western New York Health Study, who were free of type 2 diabetes and cardiovascular disease at baseline (1996-2001), were selected for reexamination. An incident case of pre-diabetes was defined as fasting glucose <100 mg/dl at the baseline examination and > or =100 and <126 mg/dl at the follow-up examination. Biomarkers of endothelial function (E-selectin and soluble intracellular adhesion molecule-1 [sICAM-1]), fibrinolysis/thrombosis (plasminogen activator inhibitor-1 [PAI-1]), and fasting insulin, adiponectin, and inflammation (high-sensitivity C-reactive protein) were measured in frozen (-190 degrees C) baseline samples.


RESULTS
Multivariate analyses revealed higher adjusted mean values of biomarkers of endothelial dysfunction (E-selectin and sICAM-1) and fibrinolysis (PAI-1) and lower mean values of adiponectin only among women who developed pre-diabetes compared with control subjects. Formal tests for interaction between sex and case/control status were statistically significant for E-selectin (P = 0.042), PAI-1 (P = 0.001), sICAM-1 (P = 0.011), and frequency of hypertension (P < 0.001).


CONCLUSIONS
These results support the concept that women who progressed from normoglycemia to pre-diabetes have greater endothelial dysfunction than men as well as more hypertension and a greater degree of fibrinolysis/thrombosis. Whether this relates to the higher risk of heart disease among diabetic women awaits further study.
Donahue
Richard P
RP
Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, 35 Main Street, Buffalo, NY 14214, USA. rpd1@buffalo.edu
Rejman
Karol
K
Rafalson
Lisa B
LB
Dmochowski
Jacek
J
Stranges
Saverio
S
Trevisan
Maurizio
M
D052242:Adiponectin / Q000097:blood; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D011236:Prediabetic State / Q000453:epidemiology*; D012307:Risk Factors; D012727:Sex Characteristics; D013927:Thrombosis / Q000453:epidemiology; D013997:Time Factors
D052242:Adiponectin; D015415:Biomarkers