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Effect of type 1 diabetes on the gender difference in coronary artery calcification: a role for insulin resistance? The coronary artery calcification in type 1 diabetes (CACTI) study
- Source :
- Diabetes. November 2003, Vol. 52 Issue 11, p2833, 7 p.
- Publication Year :
- 2003
-
Abstract
- Diabetic patients experience higher cardiovascular disease incidence and mortality (1,2). In patients with type 1 diabetes, coronary artery disease (CAD) occurs earlier in life (3) and affects women almost as [...]<br />The objective of this is study was to examine whether estimated insulin resistance and insulin resistance-related factors are associated with coronary artery calcification (CAC) in 1,420 asymptomatic participants in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study. A total of 656 patients with type 1 diabetes and 764 control subjects aged 20-55 years were examined. CAC was assessed by electron-beam computed tomography. Insulin resistance was computed with linear regression based on an equation previously validated in clamp studies on type 1 diabetic adults. Insulin resistance was associated with CAC (OR 1.6 in type 1 diabetes and 1.4 in control subjects, P < 0.001), independent of coronary artery disease risk factors. There was a male excess of CAC in control subjects (OR 2.7, adjusted for age, smoking, and LDL and HDL cholesterol levels) and in type 1 diabetic patients (OR 2.2, adjusted for the same factors and diabetes duration). After adjusting for insulin resistance, the CAC male excess in diabetic patients decreased from OR 2.2 (P < 0.001) to 1.8 (P = 0.04). After adjustment for waist-to-hip ratio, waist circumference, or visceral fat, the gender difference in CAC was not significant in diabetic subjects. In conclusion, gender differences in insulin resistance-associated fat distribution may explain why type 1 diabetes increases coronary calcification in women relatively more than in men.
Details
- Language :
- English
- ISSN :
- 00121797
- Volume :
- 52
- Issue :
- 11
- Database :
- Gale General OneFile
- Journal :
- Diabetes
- Publication Type :
- Periodical
- Accession number :
- edsgcl.110162120