title: Lipid and non-lipid cardiovascular risk factors in postmenopausal type 2 diabetic women with and without coronary heart disease.
abstract: BACKGROUND
  Coronary heart disease (CHD) is the leading cause of death in diabetic women. In addition to hyperglycemia, other factors may contribute to the excessive cardiovascular risk.
  
  
  OBJECTIVE
  In this study we evaluated common and emerging risk factors in a selected group of postmenopausal type 2 diabetic women with (n = 36) and without CHD (n = 59), not taking lipid-lowering medications.
  
  
  METHODS
  Clinical and lifestyle data were collected, and metabolic and lipid profile, as well as fasting plasma levels of total homocysteine (tHcy), folate, vitamin B12, C-reactive protein (hsCRP), interleukin 6 (IL-6), and vascular cell adhesion molecule-1 (VCAM-1) were measured in all participants.
  
  
  RESULTS
  Age, menopause and diabetes duration, family history for cardiovascular disease, prevalence of hypertension and current insulin use were greater in diabetic women with than without CHD (P < 0.05 for all comparisons). CHD women also showed higher levels of triglycerides, small dense LDL (sdLDL), remnant-like particle cholesterol, tHcy, and VCAM-1, and a lower creatinine clearance (P < 0.05 all). Conversely, the two groups were comparable for BMI, waist circumference, smoking habit, fasting plasma glucose, HbA1c, total cholesterol, low-density lipoprotein cholesterol (LDL-C), HDL cholesterol, folate, vitamin B12, hsCRP and IL-6 levels. At multivariate analysis, lower creatinine clearance (OR = 0.932, P = 0.017) and higher sdLDL serum concentration (OR = 1.224, P = 0.037) were the strongest risk factors associated with CHD in this population, whereas no significant association was noted with LDL-C.
  
  
  CONCLUSIONS
  Our data suggest that beyond LDL-C, a lower creatinine clearance and more subtle alterations of LDL particles, together with a constellation of several well known and emerging cardiovascular risk factors, are stronger contributors to the high CHD risk of diabetic women.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy, giuseppina.russo@unime.it.
authors.forename: G T
authors.initials: GT
authors.lastname: Russo
authors.forename: A
authors.initials: A
authors.lastname: Giandalia
authors.forename: E L
authors.initials: EL
authors.lastname: Romeo
authors.forename: M
authors.initials: M
authors.lastname: Marotta
authors.forename: A
authors.initials: A
authors.lastname: Alibrandi
authors.forename: C
authors.initials: C
authors.lastname: De Francesco
authors.forename: K V
authors.initials: KV
authors.lastname: Horvath
authors.forename: B
authors.initials: B
authors.lastname: Asztalos
authors.forename: D
authors.initials: D
authors.lastname: Cucinotta
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D048909:Diabetes Complications / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood*; D008875:Middle Aged; D017698:Postmenopause; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008055:Lipids