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

Cardiovascular Diabetology

LOD-DIABETES Group⁴  Luís García-Ortiz²  Marta Gomez-Sanchez³  JoseAngel Maderuelo-Fernandez¹  Emiliano Rodríguez-Sanchez²  Cristina Agudo-Conde¹  Leticia Gómez-Sánchez³  José Ignacio Recio-Rodríguez³  Manuel Ángel Gómez-Marcos² 

[1] Castilla and León Health Service–SACYL. REDIAPP, IBSAL, Salamanca, Spain;Medicine Department, University of Salamanca, Salamanca, Spain;Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, Salamanca, 37003, Spain;LOD-DIABETES Group, redIAPP: Research Network on Preventive Activities and Health Promotion, Salamanca, 37003, Spain

关键词: Drug treatment;    Gender difference;    Target organ damage;    Insulin resistance;   

Others  :  1228713
DOI  :  10.1186/s12933-015-0293-1

 received in 2015-07-03, accepted in 2015-09-17,  发布年份 2015

【 摘 要 】

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

【 授权许可】

   
2015 Gómez-Marcos et al.

【 图 表 】

Fig.1.

Fig.2.

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