Diabetes, abdominal adiposity, and atherogenic dyslipoproteinemia in women compared with men.
OBJECTIVE
To understand why atherogenic risk differs more between diabetic and nondiabetic women than between diabetic and nondiabetic men.


RESULTS
Measures of cardiovascular risk, body composition, and serum hormones from the baseline examinations of the Insulin Resistance Atherosclerosis Study on 524 nondiabetic women, 258 diabetic women, 421 nondiabetic 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-to-apoA-I ratio; non-HDL cholesterol; LDL particle count, small LDL, and intermediate-density lipoprotein by nuclear magnetic resonance; and C-reactive protein exhibited significant diabetes-sex interaction (P < 0.05). ApoB exhibited the most significant interaction (P = 0.0005). Age- and ethnicity-adjusted apoB means were lower in nondiabetic women than nondiabetic men (102.4 vs. 106.8 mg/dl, P < 0.05) but higher in diabetes (115.7 vs. 110.2 mg/dl, P < 0.01). Plotted against BMI, waist circumference was 6% higher and hip circumference 10% lower in diabetic than nondiabetic women (both P < 0.05), whereas the circumference measures did not differ conspicuously between diabetic and nondiabetic men.


CONCLUSIONS
In diabetic women, an elevated level of atherogenic particles, as manifested by apoB and LDL particle count, which may result from abdominal adiposity, represents a major treatable cardiovascular risk factor.
Williams
Ken
K
KenAnCo Biostatistics, San Antonio, TX, USA. ken@kenanco.com
Tchernof
Andre
A
Hunt
Kelly J
KJ
Wagenknecht
Lynne E
LE
Haffner
Steven M
SM
Sniderman
Allan D
AD
D000005:Abdomen / Q000473:pathology*; D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000473:pathology*; D050171:Dyslipidemias / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D012727:Sex Characteristics
D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D001786:Blood Glucose