Severity of coronary artery disease in postmenopausal diabetic women.
OBJECTIVE
Coronary artery disease (CAD) risk increases in women after the menopause. The aim of this study was to determine the effect of diabetes on the severity of CAD in postmenopausal women undergoing coronary angiography.


METHODS
180 postmenopausal women underwent coronary angiography for suspected CAD. CAD severity was assessed by the number of arteries (0-3) with >50% stenosis in the angiography. Forty-four women had type 2 diabetes mellitus (T2DM). Predisposing risk factors and biochemical and hormonal parameters were recorded. The diabetic women were older (p=0.014), had higher BMI and waist circumference (p<0.001), higher prevalence of hypertension (p=0.002), higher levels of triglycerides, uric acid and higher HOMA-Insulin Resistance Index (p=0.009).


RESULTS
The women with diabetes had a higher prevalence of severe stenosis in the angiography: T2DM: 0-vessels 25%, 1-vessel disease 18.2%, 2-vessels disease 22.7%, 3-vessels disease 34.1%, vs. 49.2%, 23.5%, 22.1%, 5.1% in the non-diabetic women, respectively (p<0.001). Binary logistic regression analysis showed that T2DM was a significant predictor of severe CAD (>or=3 vessel disease) independently of age, family history of T2DM, BMI, time since menopause, hypertension and hypercholesterolemia. Women with T2DM also had lower sex hormone binding globulin (SHBG, p=0.010) levels compared to non-diabetic women.


CONCLUSIONS
Diabetic postmenopausal women develop more severe CAD compared to non-diabetic women. This association is independent of other predisposing factors and suggests an independent effect of T2DM on the atherosclerotic process, at least in women after menopause.
Saltiki
Katerina
K
Endocrine Unit, Evgenidion Hospital and Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece. saze@otenet.gr
Cimponeriu
Adrianna
A
Lili
Kyriaki
K
Peppa
Melpomeni
M
Anastasiou
Eleni
E
Alevizaki
Maria
M
D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index