Sex differences in cardiovascular disease risk in adolescents with type 1 diabetes.
BACKGROUND
Cardiovascular disease is seen at a younger age and at a higher prevalence in patients with type 1 diabetes than in the general population. It is well described that women with type 1 diabetes have a higher relative risk of cardiovascular disease than men with type 1 diabetes, unlike that seen in the general population. The pathophysiology behind this is unknown.


OBJECTIVE
We performed a cross-sectional study to examine sex differences in cardiovascular disease risk factors in adolescents with type 1 diabetes between ages 13 and 20 years, compared with children of a similar age without type 1 diabetes.


METHODS
All patients underwent a dual energy x-ray absorptiometry scan to measure body composition and a pulse wave test measure of arterial elasticity. Fasting serum lipid levels, apolipoprotein B, and apolipoprotein C-III levels were measured in each patient. Twenty-nine children with type 1 diabetes (10 girls, 19 boys) and 37 healthy children (18 girls, 19 boys) participated.


RESULTS
Although no sex differences for body mass index (P = 0.91) and glycosylated hemoglobin (P = 0.69) were seen, girls with type 1 diabetes had a significantly higher percent trunk fat compared with boys (P = 0.004). No sex differences were found (P > 0.05) for percent trunk fat in adolescents without diabetes. There was no sex difference among any other cardiovascular risk factors in either children with or without diabetes.


CONCLUSIONS
Female adolescents with type 1 diabetes have more centrally distributed fat, which may contribute to their relatively higher cardiovascular disease risk. Attenuation of the central distribution of fat through exercise and dietary modifications may help ameliorate their subsequent cardiovascular disease burden.
Children's Medical Research Institute Diabetes and Metabolic Research Program, Section of Diabetes and Endocrinology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. sowmya-krishnan@ouhsc.edu
Sowmya
S
Krishnan
David A
DA
Fields
Kenneth C
KC
Copeland
Piers R
PR
Blackett
Michael P
MP
Anderson
Andrew W
AW
Gardner
D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology; D012727:Sex Characteristics; D017678:Sex Distribution; D055815:Young Adult