The spiral towards diabetes and coronary heart disease may begin earlier for women with prediabetes than for men, a US study has found.
Among healthy adults who developed prediabetes during a six-year period, women started off with greater endothelial dysfunction, more hypertension and a greater degree of thrombosis than did men, report Dr Richard P. Donahue, of the State University of New York at Buffalo, and colleagues in the February issue of Diabetes Care.
The results endorse the “ticking clock” hypothesis used to explain the higher coronary heart disease risk seen for women with diabetes than for men with diabetes, they add. This hypothesis claims that the cardiovascular risk and diabetes may be linked more through longstanding atherogenic risk factors than through hyperglycemia alone.
“Although observational studies cannot prove causality, our data add compelling new evidence that the clock may indeed start ticking earlier among women than among men,” Dr. Donahue and colleagues wrote.
In the study, female gender was significantly linked to factors emerging as precursors of coronary heart disease and type 2 diabetes, including the endothelial markers E-selectin and soluble intracellular adhesion molecule-1,fibrinolysis/thrombosis marker plasminogen activator inhibitor-1, and frequency of hypertension.
“These novel and important observations support a role for endothelial dysfunction in the progression to pre-diabetes,” they added.
Donahue and his colleagues at the State University of New York at Buffalo based their findings on 1,455 adults who were free of diabetes and heart disease at the study’s outset. All were 39 to 79 years old.
Comparing the pre-diabetic women and men, the team found women had higher E-selectin levels (51.2 versus 40.5 ng/ml), higher levels of soluble intracellular adhesion molecule-1 (273.0 versus 254.8 ng/ml) and higher plasminogen activator inhibitor-1 levels (34.6 versus 26.8 ng/ml).
Despite the findings, the authors warn that it is premature to assume the results are related to subsequent risk of heart disease.
“Whether this relates to the higher risk of heart disease among diabetic women awaits further study,” they conclude.
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