1. Sex differences in cardiovascular disease and cardiovascular risk estimation in patients with type 1 diabetes
- Author
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Dei Cas, A, Aldigeri, R, Mantovani, A, Masulli, M, Palmisano, L, Cavalot, F, Bonomo, K, Baroni, M, Cossu, E, Cavallo, G, Cimini, F, Buzzetti, R, Mignogna, C, Leonetti, F, Bacci, S, Trevisan, R, Morieri, M, Pollis, R, Targher, G, Vigili de Kreutzenberg, S, Dei Cas, Alessandra, Aldigeri, Raffaella, Mantovani, Alessandro, Masulli, Maria, Palmisano, Luisa, Cavalot, Franco, Bonomo, Katia, Baroni, Marco Giorgio, Cossu, Efisio, Cavallo, Gisella, Cimini, Flavia Agata, Buzzetti, Raffaella, Mignogna, Carmen, Leonetti, Frida, Bacci, Simonetta, Trevisan, Roberto, Morieri, Mario Luca, Pollis, Riccardo Maria, Targher, Giovanni, Vigili de Kreutzenberg, Saula, Dei Cas, A, Aldigeri, R, Mantovani, A, Masulli, M, Palmisano, L, Cavalot, F, Bonomo, K, Baroni, M, Cossu, E, Cavallo, G, Cimini, F, Buzzetti, R, Mignogna, C, Leonetti, F, Bacci, S, Trevisan, R, Morieri, M, Pollis, R, Targher, G, Vigili de Kreutzenberg, S, Dei Cas, Alessandra, Aldigeri, Raffaella, Mantovani, Alessandro, Masulli, Maria, Palmisano, Luisa, Cavalot, Franco, Bonomo, Katia, Baroni, Marco Giorgio, Cossu, Efisio, Cavallo, Gisella, Cimini, Flavia Agata, Buzzetti, Raffaella, Mignogna, Carmen, Leonetti, Frida, Bacci, Simonetta, Trevisan, Roberto, Morieri, Mario Luca, Pollis, Riccardo Maria, Targher, Giovanni, and Vigili de Kreutzenberg, Saula
- Abstract
Aims: Patients with type 1 diabetes (T1D) have higher cardiovascular disease (CVD) risk compared to the general population. This observational study aims to evaluate sex-related differences in CVD prevalence and CVD risk estimates in a large cohort of T1D adults. Materials and methods: We conducted a multicenter, cross-sectional study involving 2,041 T1D patients (mean age 46 years; 44.9% women). In patients without pre-existing CVD (primary prevention), we calculated the Steno type 1 risk engine to estimate the 10-year risk of developing CVD events. Results: CVD prevalence (n=116) was higher in men than in women aged ≥55 years (19.2 vs 12.8%, p=0.036), but comparable between the two sexes in those aged <55 years (p=0.91). In patients without pre-existing CVD (n=1,925), mean 10-year estimated CVD risk was 15.4±0.4% without any significant sex difference. However, stratifying this patient group by age, the 10-year estimated CVD risk was significantly higher in men than in women until age 55 years (p<0.001), but this risk equalized after this age. Carotid-artery plaque burden was significantly associated with age ≥55 years and with a medium and high 10-year estimated CVD risk, without any significant sex difference. Diabetic retinopathy and sensory-motor neuropathy were also associated with higher 10-year CVD risk and female sex. Conclusions: Both men and women with T1D are at high CVD risk. The 10-year estimated CVD risk was higher in men aged <55 years than in women of similar age, but these sex differences disappeared at age ≥55 years, suggesting that female sex was no longer protective.
- Published
- 2023