Impact of Gender Differences and Glycated Haemoglobin on Atherosclerosis Risk in Type 2 Diabetic Patients from North Western Algeria

Imane BOURAGBA; Hannane BOULARBAG; Mustapha DIAF

doi:10.21467/ajgr.8.1.51-57

Authors

Imane BOURAGBA Department of Biology, Faculty of Natural and Life Sciences, Djillali LIABES University, Sidi-Bel-AbbÃ¨s, Algeria
Hannane BOULARBAG Department of Biology, Faculty of Natural and Life Sciences, Djillali LIABES University, Sidi-Bel-AbbÃ¨s, Algeria
Mustapha DIAF Biology Department, Faculty of Natural and Life Sciences, Djillali LIABES University of Sidi-Bel-AbbÃ¨s, Algeria https://orcid.org/0000-0001-6065-6659

DOI:

https://doi.org/10.21467/ajgr.8.1.51-57

Abstract

In type 2 diabetic patients, blood lipids and lipid ratios have been proven to be associated with atherosclerosis risk; however, results about the effect of gender differences had not been fully conclusive. In this transversal comparative study, a total of 129 adult type 2 diabetic patients (54 men and 75 women), from north western Algeria, was included to highlight the impact of gender differences on atherosclerosis risk (assessed by lipid ratios) according to their diabetic profile. Comparing between the two genders, no significant differences (p>0.05) were noted on diabetes duration, central obesity, body mass index and blood pressures. Moreover, the basic biochemical parameters of both glycaemic and lipid metabolism were not meaningfully divergent. However, higher significant values (p<0.05) of body weight, height, HbA1c levels, HDL and lipid ratios (TC/HDL, LDL/HDL and TG/HDL) were observed in male patients comparing to females. According to the HbA1c levels (HbA1c<7%vs. HbA1c≥ 7%); notable higher CT/HDL, LDL/HDL and TG/HDL in male patients comparing to women were found. The rates of these three lipid ratios were often higher in both classes of HbA1c. The consideration of gender differences is very important for prevention, diagnosis, treatment and management of atherosclerosis and CVD. The disparity in atherogenic risk, in both genders, estimated by lipid ratios need to be critically examined. Further, interventional studies are needed to determine how sex can modulate the impacts of diabetes control parameters on atherosclerosis risk.

Keywords:

lipid ratios, atherosclerosis, type 2 diabetes, gender difference, diabetes control

Downloads

Download data is not yet available.

References

Global Status Report on Non communicable Diseases 2010, World Health Organization, Geneva, 2011.

C. D. Mathers, D. Loncar, “Projections of global mortality and burden of disease from 2002 to 2030”, PLoS Med., vol. 3, no. 11, pp. e442, November 2006.

L. La Sala, F. Prattichizzo, A. Ceriello, “The link between diabetes and atherosclerosis”, Eur. J. Prev. Cardiol., vol. 26, no. Suppl 2, pp. 15-24, December 2019.

W. Weng, Y. Tian, S. X. Kong, R. Ganguly, M. Hersloev, J. Brett, T. Hobbs, “Impact of atherosclerotic cardiovascular disease on healthcare resource utilization and costs in patients with type 2 diabetes mellitus in a real-world setting”, Clin. Diabetes Endocrinol., vol. 6, no. 5, March 2020.

Y. Akalu, A. Birhan, “Peripheral Arterial Disease and Its Associated Factors among Type 2 Diabetes Mellitus Patients at Debre Tabor General Hospital, Northwest Ethiopia”, J. Diabetes Res., vol. 2020, no. 9419413, pp. 1-9, January 2020.

American Diabetes Association, “8. Cardiovascular Disease and Risk Management”, Diabetes Care, vol. 39, no. Suppl 1, pp. S60-S71, January 2016.

A. H. Maas, Y. E. Appelman, “Gender differences in coronary heart disease”, Neth. Heart J., vol. 18, no. 12, pp. 598-602, December 2010.

R. Madonna, C. R. Balistreri, S. De Rosa, S. Muscoli, S. Selvaggio, G. Selvaggio, P. Ferdinandy, R. De Caterina, “Impact of Sex Differences and Diabetes on Coronary Atherosclerosis and Ischemic Heart Disease”, J. Clin. Med., vol. 8, no. 1, pp. E98, January 2019.

Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report, “Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung Lung, and Blood Institute”, Pediatrics, vol. 128, no. Suppl 5, pp. S213-56, December 2011.

J. Wen, Y. Zhong, C. Kuang, J. Liao, Z. Chen, Q. Yang, “Lipoprotein ratios are better than conventional lipid parameters in predicting arterial stiffness in young men”, J. Clin. Hypertens., vol. 19, no. 8, pp. 771-6, August 2017.

N. H. Cho, J. E. Shaw, S. Karuranga, Y. Huang, J. D. da Rocha Fernandes, A. W. Ohlrogge, B. Malanda, “IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045”, Diabetes Res. Clin. Pract., vol. 138, pp. 271-281, April 2018.

Q. Zhou, Y. Bei, “Editorial: Gender Differences in Cardiovascular Diseases”, J. Cardiovasc. Transl. Res., vol. 13, no. 1, pp. 1-2, February 2020.

P. Mathur, B. Ostadal, F. Romeo, J. L. Mehta, “Gender-Related Differences in Atherosclerosis”, Cardiovasc. Drugs. Ther., vol. 29, no. 4, pp. 319-27, August 2015.

D. Fairweather, “Sex differences in inflammation during atherosclerosis”, Clin. Med. Insights Cardiol., vol. 8, no. Suppl 3, pp. 49-59, April 2015.

M. Hegazy, S. A. Saleh, A. Ezzat, M. E. Behiry, “Novel Application of the Traditional Lipid Ratios as Strong Risk Predictors of NASH”, Diabetes Metab. Syndr. Obes., vol. 10, no. 13, pp. 297-305, February 2020.

F. Mach, C. Baigent, A. L. Catapano, K. C. Koskinas, M. Casula, L. Badimon, M. J. Chapman, G. G. De Backer, V. Delgado, B. A. Ference, I. M. Graham, A. Halliday, U. Landmesser, B. Mihaylova, T. R. Pedersen, G. Riccardi, D. J. Richter, M. S. Sabatine, M. R. Taskinen, L. Tokgozoglu, O. Wiklund, “2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk”, Eur. Heart J., vol. 41, no. 1, pp. 111-188, January 2020.

V. L. Roger, A. S. Go, D. M. Lloyd-Jones, R. J. Adams, J. D. Berry, T. M. Brown, et al., “Heart disease and stroke statistics–2011 update: a report from the American Heart Association”, Circulation, vol. 123, no. 4, pp. 276-308, February 2011.

L. J. Shaw, R. Bugiardini, C. N. B. Merz, “Women and ischemic heart disease: evolving knowledge”, J. Am. Coll. Cardiol., vol. 54, no. 17, pp. 1561-75, October 2009.

H. Shih, B. Lee, R. J. Lee, A. J. Boyle, “The aging heart and post-infarction left ventricular remodeling”, J. Am. Coll. Cardiol., vol. 57, no. 1, pp. 9-17, January 2011.

M. Izadnegahdar, J. Singer, M. K. Lee, M. Gao, C. R. Thompson, J. Kopec, et al., “Do younger women fare worse? Sex differences in acute myocardial infarction hospitalization and early mortality rates over ten years”, J. Womens Health (Larchmt), vol. 23, no. 1, pp. 10-7, January 2014.

F.B. Sozzi, G. B. Danzi, L. Foco, M. Ferlini, M. Tubaro, M. Galli, et al., “Myocardial infarction in the young: a sex-based comparison”, Coron. Artery Dis., vol. 18, no. 6, pp. 429-31, September 2007.

L. A. Leiter, J. Genest, S. B Harris, G. Lewis, R. McPherson, G. Steiner, et al., “Dyslipidemia in adults with diabetes”, Can. J. Diabetes, vol. 30, no. 3, pp. 230-40, 2006.

T. Pereira, “Dyslipidemia and cardiovascular risk: lipid ratios as risk factors for cardiovascular disease”. In: Dyslipidemia_from prevention to treatment, R. Kelishadi Eds. InTech, 2012, pp. 279-302.

Aderibigbe MA, Obafemi TO, Olaleye MT, Akinmoladun AC. Effects of gender, age and treatment duration on lipid profile and renal function indices in diabetic patients attending a teaching hospital in South-Western Nigeria. Afr Health Sci 18, 900-908, 2018.

S. Antwi-Baffour, R. Kyeremeh, S. O. Boateng, L. Annison, M. A. Seidu, “Haematological parameters and lipid profile abnormalities among patients with Type-2 diabetes mellitus in Ghana”, Lipids Health Dis., vol. 17, no. 1, pp. 213, December 2018.

M. Rezapour, A. Shahesmaeili, A. Hossinzadeh, R. Zahedi, H. Najafipour, M. H. Gozashti, “Comparison of Lipid Ratios to Identify Metabolic Syndrome”, Arch. Iran. Med., vol. 21, no. 12, pp. 572-7, December 2018.

P. Ballotari, F. Venturelli, M. Greci, P. Giorgi Rossi, V. Manicardi, “Sex Differences in the Effect of Type 2 Diabetes on Major Cardiovascular Diseases: Results from a Population-Based Study in Italy”, Int. J. Endocrinol., 2017; 2017: 6039356.

R. Huxley, F. Barzi, M. Woodward, “Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies”, BMJ, vol. 332, no. 7533, pp. 73-8, January 2006.

Z. Gao, Z. Chen, A. Sun, X. Deng, “Gender differences in cardiovascular disease”. Medicine in Novel Technology and Devices, vol. 4, pp. 100025, December 2019.