Gender Difference in Albuminuria and Ischemic Heart Disease in Type 2 Diabetes

Abstract

Objective: The value of urinary albumin excretion in the prediction of myocardial ischemia in men and women with type 2 diabetes is not well understood. We questioned whether gender influences the albuminuria-ischemic heart disease relationship in patients with type 2 diabetes. Methods:We designed a matched case-control study of 926 patients with albuminuria (cases) and 926 age and body mass index matched patients without albuminuria (controls). Ischemic heart disease was defined as the presence of (1) history of angina pectoris or angina equivalent symptoms and critical care unit admission, (2) myocardial infarction and/or electrocardiographic evidence of Q-wave myocardial infarction, (3) coronary revascularization and/or stenting, (4) positive myocardial singlephoton emission computed tomography scan, (5) ischemic ST-segment or T-wave changes, and (6) positive stress testing. Results:Patients with albuminuria had a lower glomerular filtration rate and a longer diabetes duration than patients without albuminuria. In the group of cases, there were a greater number of men with ischemic heart disease (120 of 370; 32.4%) compared to women (97 of 559; 17.4%) (P<0.001). The odds ratio of having ischemic heart disease according to the presence or absence of albuminuria was 1.25 [95% CI: 1.01-1.56] (P<0.05) in all studied populations, 0.79 [95% CI: 0.51-1.21] (P=0.14) in women, and 2.84 [95% CI: 1.68-4.79] (P<0.001) in men. We showed that diabetes duration, high-density lipoprotein, low-density lipoprotein, and hemoglobin A 1c influence albuminuria in women, while diabetes duration, fasting blood sugar, and diastolic blood pressure influence albuminuria in men. Conclusions:Men with albuminuria are at increased risk of ischemic heart disease compared to women. This may be related to the role of high-density lipoprotein on the albuminuria-gender relationship.

Evaluation of plasma MMP-8, MMP-9 and TIMP-1 identifies candidate cardiometabolic risk marker in metabolic syndrome: results from double-blinded nested case–control study

“…Diabetes subjects began their treatment by lifestyle modification, glibenclamide, and/or metformin. Multiple crosssectional studies demonstrated the characteristics of a selected sample of the original cohort, during years of follow-up [24][25][26][27][28][29]. Surveyed population for this study was selected from 522 nondiabetic staff of a private company who were under the coverage of eastern health surveillance center ( Fig.…”

Sex differences in type 2 diabetes: focus on disease course and outcomes

“…Nearly all degrees of nephropathy are more common in men than women, with the exception of stage 5 chronic kidney disease 82. One study found albuminuria is a stronger risk factor for CVD among men with T2D compared with women 120. These differences may be due to sex differences in other factors such as hypertension 24.…”

Gender-Related Differences in HDL Structure with the Progression of Microalbuminuria in Patients with Type 2 Diabetes

“…This is consistent with a previous study where we showed that different risk factors influence albuminuria in males and females; thus HDL is considered as a risk factor for women, but not for men. 34 Furthermore, there is evidence that LCAT activity and LCAT production in women with type 2 diabetes is worse compared with men, 35 which is consistent with the gender effect on HDL functional properties.…”