Limits...
Influences of gender on cardiovascular disease risk factors in adolescents with and without type 1 diabetes.

Brown TL, Maahs DM, Bishop FK, Snell-Bergeon JK, Wadwa RP - Int J Pediatr Endocrinol (2016)

Bottom Line: Therefore, our objective was to compare CVD risk factors in adolescents with and without T1D to determine the effects of gender on CVD risk factors.Testing interactions between gender and T1D with CVD risk factors indicated that differences were greater between girls with T1D and non-DM compared to differences between boys with T1D and non-DM.The increased CVD risk factors seen in adolescent girls with T1D in particular argues for earlier intervention to prevent later increased risk of CVD in women with T1D.

View Article: PubMed Central - PubMed

Affiliation: Colorado School of Public Health, 13001 East 17th Place, Aurora, CO 80045 USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Court, Mail Stop A140, Aurora, CO 80045 USA.

ABSTRACT

Background: Women with type 1 diabetes (T1D) have a four-fold increased risk for cardiovascular disease (CVD) compared to non-diabetic (non-DM) women, as opposed to double the risk in T1D men compared to non-DM men. It is unclear how early in life CVD risk differences begin in T1D females. Therefore, our objective was to compare CVD risk factors in adolescents with and without T1D to determine the effects of gender on CVD risk factors.

Methods: The study included 300 subjects with T1D (age 15.4±2.1 years, 50 % male, 80 % non-Hispanic White (NHW), glycated hemoglobin (A1c) 8.9±1.6 %, diabetes duration 8.8±3.0 years, BMI Z-score 0.62±0.77) and 100non-DM controls (age 15.4±2.1 years, 47 % male, 69 % NHW, BMI Z-score 0.29±1.04). CVD risk factors were compared by diabetes status and gender. Multivariate linear regression analyses were used to determine if relationships between diabetes status and CVD risk factors differed by gender independent of differences in A1c and BMI.

Results: Differences in CVD risk factors between T1D subjects and non-DM controls were more pronounced in girls. Compared to boys with T1D and non-DM girls, T1D girls had higher A1c (9.0 % vs. 8.6 % and 5.1 %, respectively), BMI Z-score (0.70 vs. 0.47 and 0.27), LDL-c (95 vs. 82 and 81 mg/dL), total cholesterol (171 vs. 153 and 150 mg/dL), DBP (68 vs. 67 and 63 mmHg), and hs-CRP (1.15 vs. 0.57 and 0.54 mg/dL) after adjusting for Tanner stage, smoking status, and race/ethnicity (p <0.05 for all). In T1D girls, differences in lipids, DBP, and hs-CRP persisted even after adjusting for centered A1c and BMI Z-score. Testing interactions between gender and T1D with CVD risk factors indicated that differences were greater between girls with T1D and non-DM compared to differences between boys with T1D and non-DM. Overall, observed increases in CVD risk factors in T1D girls remained after further adjustment for centered A1c or BMI Z-score.

Conclusions: Interventions targeting CVD risk factors in addition to lowering HbA1c and maintaining healthy BMI are needed for youth with T1D. The increased CVD risk factors seen in adolescent girls with T1D in particular argues for earlier intervention to prevent later increased risk of CVD in women with T1D.

No MeSH data available.


Related in: MedlinePlus

a-h: Least Square Means for CVD risk factors stratified by gender and diabetes status and adjusted by Tanner stage, race/ethnicity, and smoking status. P-values for each respective pair-wise test are also presented in each panel. 1a-HbA1c, 1b-BMI z-score, 1c-total cholesterol, 1d-HDL-c, 1e-LDL-c, 1f-SBP, 1g-DBP, 1h-hs-CRP
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4837565&req=5

Fig1: a-h: Least Square Means for CVD risk factors stratified by gender and diabetes status and adjusted by Tanner stage, race/ethnicity, and smoking status. P-values for each respective pair-wise test are also presented in each panel. 1a-HbA1c, 1b-BMI z-score, 1c-total cholesterol, 1d-HDL-c, 1e-LDL-c, 1f-SBP, 1g-DBP, 1h-hs-CRP

Mentions: Mean levels for CVD risk factors (A1c, BMI Z-score, blood pressure, lipids, hs-CRP) adjusted for Tanner stage, race/ethnicity, and smoking status are shown by diabetes and gender status in Fig. 1. More atherogenic profiles were seen in univariate analysis in girls with T1D compared to both boys with T1D and non-DM girls. Specifically, girls with T1D had higher A1c, BMI Z-score, total cholesterol, LDL-c, DBP, and hs-CRP than boys with T1D and non-DM girls (p < 0.05 for all). Additionally, girls with T1D had higher SBP than non-DM girls. Boys with T1D had a similar CVD risk profile compared to non-DM boys, except for higher A1c, BMI Z-score and DBP. Girls with T1D also had higher adjusted HDL-c than boys with T1D and non-DM girls. There were significant diabetes by gender interactions for total cholesterol (p = 0.04), LDL-c (p = 0.02), and hs-CRP (p = 0.07). These interactions indicate that for these specific CVD risk factors, differences were much greater between girls with and without T1D compared to the differences between boys with and without T1D.Fig. 1


Influences of gender on cardiovascular disease risk factors in adolescents with and without type 1 diabetes.

Brown TL, Maahs DM, Bishop FK, Snell-Bergeon JK, Wadwa RP - Int J Pediatr Endocrinol (2016)

a-h: Least Square Means for CVD risk factors stratified by gender and diabetes status and adjusted by Tanner stage, race/ethnicity, and smoking status. P-values for each respective pair-wise test are also presented in each panel. 1a-HbA1c, 1b-BMI z-score, 1c-total cholesterol, 1d-HDL-c, 1e-LDL-c, 1f-SBP, 1g-DBP, 1h-hs-CRP
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837565&req=5

Fig1: a-h: Least Square Means for CVD risk factors stratified by gender and diabetes status and adjusted by Tanner stage, race/ethnicity, and smoking status. P-values for each respective pair-wise test are also presented in each panel. 1a-HbA1c, 1b-BMI z-score, 1c-total cholesterol, 1d-HDL-c, 1e-LDL-c, 1f-SBP, 1g-DBP, 1h-hs-CRP
Mentions: Mean levels for CVD risk factors (A1c, BMI Z-score, blood pressure, lipids, hs-CRP) adjusted for Tanner stage, race/ethnicity, and smoking status are shown by diabetes and gender status in Fig. 1. More atherogenic profiles were seen in univariate analysis in girls with T1D compared to both boys with T1D and non-DM girls. Specifically, girls with T1D had higher A1c, BMI Z-score, total cholesterol, LDL-c, DBP, and hs-CRP than boys with T1D and non-DM girls (p < 0.05 for all). Additionally, girls with T1D had higher SBP than non-DM girls. Boys with T1D had a similar CVD risk profile compared to non-DM boys, except for higher A1c, BMI Z-score and DBP. Girls with T1D also had higher adjusted HDL-c than boys with T1D and non-DM girls. There were significant diabetes by gender interactions for total cholesterol (p = 0.04), LDL-c (p = 0.02), and hs-CRP (p = 0.07). These interactions indicate that for these specific CVD risk factors, differences were much greater between girls with and without T1D compared to the differences between boys with and without T1D.Fig. 1

Bottom Line: Therefore, our objective was to compare CVD risk factors in adolescents with and without T1D to determine the effects of gender on CVD risk factors.Testing interactions between gender and T1D with CVD risk factors indicated that differences were greater between girls with T1D and non-DM compared to differences between boys with T1D and non-DM.The increased CVD risk factors seen in adolescent girls with T1D in particular argues for earlier intervention to prevent later increased risk of CVD in women with T1D.

View Article: PubMed Central - PubMed

Affiliation: Colorado School of Public Health, 13001 East 17th Place, Aurora, CO 80045 USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Court, Mail Stop A140, Aurora, CO 80045 USA.

ABSTRACT

Background: Women with type 1 diabetes (T1D) have a four-fold increased risk for cardiovascular disease (CVD) compared to non-diabetic (non-DM) women, as opposed to double the risk in T1D men compared to non-DM men. It is unclear how early in life CVD risk differences begin in T1D females. Therefore, our objective was to compare CVD risk factors in adolescents with and without T1D to determine the effects of gender on CVD risk factors.

Methods: The study included 300 subjects with T1D (age 15.4±2.1 years, 50 % male, 80 % non-Hispanic White (NHW), glycated hemoglobin (A1c) 8.9±1.6 %, diabetes duration 8.8±3.0 years, BMI Z-score 0.62±0.77) and 100non-DM controls (age 15.4±2.1 years, 47 % male, 69 % NHW, BMI Z-score 0.29±1.04). CVD risk factors were compared by diabetes status and gender. Multivariate linear regression analyses were used to determine if relationships between diabetes status and CVD risk factors differed by gender independent of differences in A1c and BMI.

Results: Differences in CVD risk factors between T1D subjects and non-DM controls were more pronounced in girls. Compared to boys with T1D and non-DM girls, T1D girls had higher A1c (9.0 % vs. 8.6 % and 5.1 %, respectively), BMI Z-score (0.70 vs. 0.47 and 0.27), LDL-c (95 vs. 82 and 81 mg/dL), total cholesterol (171 vs. 153 and 150 mg/dL), DBP (68 vs. 67 and 63 mmHg), and hs-CRP (1.15 vs. 0.57 and 0.54 mg/dL) after adjusting for Tanner stage, smoking status, and race/ethnicity (p <0.05 for all). In T1D girls, differences in lipids, DBP, and hs-CRP persisted even after adjusting for centered A1c and BMI Z-score. Testing interactions between gender and T1D with CVD risk factors indicated that differences were greater between girls with T1D and non-DM compared to differences between boys with T1D and non-DM. Overall, observed increases in CVD risk factors in T1D girls remained after further adjustment for centered A1c or BMI Z-score.

Conclusions: Interventions targeting CVD risk factors in addition to lowering HbA1c and maintaining healthy BMI are needed for youth with T1D. The increased CVD risk factors seen in adolescent girls with T1D in particular argues for earlier intervention to prevent later increased risk of CVD in women with T1D.

No MeSH data available.


Related in: MedlinePlus