Sex-specific differences in long-term glycemic control and cardiometabolic parameters in patients with type 1 diabetes treated at a tertiary care centre: gender aspects in type 1 diabetes.
BACKGROUND
Time-dependent changes in glycemic control might represent a strong predictor for coronary artery disease. Since a higher benefit from outpatient appointments has been discussed for female gender, the aim of the study was to assess gender differences in HbA1c levels and metabolic parameters at baseline as well as over 3 years of follow-up.


METHODS
We analyzed the data of 54 female and 65 male type 1 diabetic patients, with comparable age and diabetes duration, who visited our diabetes outpatient clinic in the year 2006 as well as the follow-up visits until 2009.


RESULTS
In 2006, females showed higher HbA1c levels as compared to male subjects (8.59 ± 1.60 vs. 7.75 ± 1.41, p = 0.003). Longitudinal analysis revealed that the decrease in HbA1c until 2009 was more pronounced in women (decreased to 7.52 ± 1.00) than in men (decreased to 7.50 ± 0.99, p (sex:time) = 0.006); however, the significance was lost after adjusting for baseline levels. Further, females showed higher levels in total-cholesterol (p = 0.001), LDL-cholesterol (p = 0.033), and HDL-cholesterol (p < 0.001) at baseline, whereas males had higher creatinine (p = 0.001) and uric acid levels (p < 0.001). No differences between the two sexes were shown for triglycerides at 2006. Additionally, uric acid levels were negatively associated with long term glycemic control, particularly in male patients.


CONCLUSIONS
Sex-related differences in metabolic parameters are present in patients with type 1 diabetes. Especially, our data suggests more adverse cardiometabolic risk markers in females. A potentially protective effect for hyperuricemia by hyperglycemia-related glucosuria is lacking in female patients with type 1 diabetes.
Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Christian S
CS
Göbl
Latife
L
Bozkurt
Johannes
J
Lueck
Mona
M
El-Samahi
Peter
P
Grösser
Martin
M
Clodi
Anton
A
Luger
Alexandra
A
Kautzky-Willer
D000293:Adolescent; D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human