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Gender differences in the progression of target organ damage in patients with increased insulin resistance: the LOD-DIABETES study.

Gómez-Marcos MÁ, Recio-Rodríguez JI, Gómez-Sánchez L, Agudo-Conde C, Rodríguez-Sanchez E, Maderuelo-Fernandez J, Gomez-Sanchez M, García-Ortiz L, LOD-DIABETES Gro - Cardiovasc Diabetol (2015)

Bottom Line: HbA1c was positively associated with PWV (β = 0.501; p = 0.014).The PWV increase showed a positive association with mean HbA1c levels during the follow-up.Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. magomez@usal.es.

ABSTRACT

Background: The purpose of this study was to analyze the evolution of vascular, cardiac and renal target organ damage (TOD) in patients with increased insulin resistance over a 3.5 year follow-up and to investigate gender difference and factors that influence its progression.

Methods: We performed a prospective observational study involving 112 patients (71 men, 41 women) who were followed for 3.5 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and HOMA-Ir Vascular TOD included carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI). Cardiac TOD included Cornell voltage-duration product and Sokolow. Renal TOD included creatinine, glomerular filtration and albumin/creatinine ratio.

Results: The IMT increased in both genders. Each year, the IMT increased 0.005 mm in men and 0.011 in women and the PWV 0.024 and 0.020 m/sec, respectively. The highest increase was in women with type 2 diabetes mellitus, who had an increase in TOD carotid (40%), PWV (24%) and renal TOD (20 %). Multiple regression analysis, after adjusting for age and gender, showed a negative association between duration since diabetes diagnosis and ABI (β = -0.006; p = 0.017) and between BMI and glomerular filtration (β = -0.813; p = 0.014). HbA1c was positively associated with PWV (β = 0.501; p = 0.014).

Conclusions: This study showed that the progression of vascular and renal TOD differs by gender. The increase in vascular and renal TOD was higher in women, especially in diabetic women. The PWV increase showed a positive association with mean HbA1c levels during the follow-up. Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

Trial registration: Clinical Trials.gov Identifier NCT01065155.

No MeSH data available.


Related in: MedlinePlus

Study flow chart. The subjects analyzed each year are presented in the flow chart. Additional information includes cardiovascular events in each group and evaluation of patients by gender
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Fig1: Study flow chart. The subjects analyzed each year are presented in the flow chart. Additional information includes cardiovascular events in each group and evaluation of patients by gender

Mentions: In the first year of follow-up, two men died as result of acute myocardial infarction. Subsequently, two non-fatal cardiovascular events occurred in the male group. In the female group, there was a non-fatal cardiovascular event. The flow chart is shown in Fig. 1.Fig. 1


Gender differences in the progression of target organ damage in patients with increased insulin resistance: the LOD-DIABETES study.

Gómez-Marcos MÁ, Recio-Rodríguez JI, Gómez-Sánchez L, Agudo-Conde C, Rodríguez-Sanchez E, Maderuelo-Fernandez J, Gomez-Sanchez M, García-Ortiz L, LOD-DIABETES Gro - Cardiovasc Diabetol (2015)

Study flow chart. The subjects analyzed each year are presented in the flow chart. Additional information includes cardiovascular events in each group and evaluation of patients by gender
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591592&req=5

Fig1: Study flow chart. The subjects analyzed each year are presented in the flow chart. Additional information includes cardiovascular events in each group and evaluation of patients by gender
Mentions: In the first year of follow-up, two men died as result of acute myocardial infarction. Subsequently, two non-fatal cardiovascular events occurred in the male group. In the female group, there was a non-fatal cardiovascular event. The flow chart is shown in Fig. 1.Fig. 1

Bottom Line: HbA1c was positively associated with PWV (β = 0.501; p = 0.014).The PWV increase showed a positive association with mean HbA1c levels during the follow-up.Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. magomez@usal.es.

ABSTRACT

Background: The purpose of this study was to analyze the evolution of vascular, cardiac and renal target organ damage (TOD) in patients with increased insulin resistance over a 3.5 year follow-up and to investigate gender difference and factors that influence its progression.

Methods: We performed a prospective observational study involving 112 patients (71 men, 41 women) who were followed for 3.5 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and HOMA-Ir Vascular TOD included carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI). Cardiac TOD included Cornell voltage-duration product and Sokolow. Renal TOD included creatinine, glomerular filtration and albumin/creatinine ratio.

Results: The IMT increased in both genders. Each year, the IMT increased 0.005 mm in men and 0.011 in women and the PWV 0.024 and 0.020 m/sec, respectively. The highest increase was in women with type 2 diabetes mellitus, who had an increase in TOD carotid (40%), PWV (24%) and renal TOD (20 %). Multiple regression analysis, after adjusting for age and gender, showed a negative association between duration since diabetes diagnosis and ABI (β = -0.006; p = 0.017) and between BMI and glomerular filtration (β = -0.813; p = 0.014). HbA1c was positively associated with PWV (β = 0.501; p = 0.014).

Conclusions: This study showed that the progression of vascular and renal TOD differs by gender. The increase in vascular and renal TOD was higher in women, especially in diabetic women. The PWV increase showed a positive association with mean HbA1c levels during the follow-up. Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis.

Trial registration: Clinical Trials.gov Identifier NCT01065155.

No MeSH data available.


Related in: MedlinePlus