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Open Access Original investigation

Diabetes abrogates sex differences and aggravates cardiometabolic risk in postmenopausal women

Filipa Mascarenhas-Melo1, Daniela Marado2, Filipe Palavra13, José Sereno1, Álvaro Coelho2, Rui Pinto4, Edite Teixeira-Lemos15, Frederico Teixeira1 and Flávio Reis1*

Author Affiliations

1 Laboratory of Pharmacology & Experimental Therapeutics, IBILI, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, Coimbra, 3000-548, Portugal

2 Internal Medicine Department, General Hospital, University and Hospital Centre of Coimbra, Quinta dos Vales, S. Martinho do Bispo, Coimbra, 3041-801, Portugal

3 Neurology Department, General Hospital, University and Hospital Centre of Coimbra, Quinta dos Vales, S. Martinho do Bispo, Coimbra, 3041-801, Portugal

4 Pharmacology and Pharmacotoxicology Unit, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, Lisbon, 1649-003, Portugal

5 ESAV, Polytechnic Institute of Viseu, Av. Cor. José Maria Vale de Andrade, Campus Politécnico, Viseu, 3504-510, Portugal

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Cardiovascular Diabetology 2013, 12:61  doi:10.1186/1475-2840-12-61

Published: 9 April 2013

Abstract

Background

The aim of this study is to evaluate the effect of gender and menopause in cardiometabolic risk in a type 2 diabetes mellitus (T2DM) population, based on classical and non-traditional markers.

Methods

Seventy four volunteers and 110 T2DM patients were enrolled in the study. Anthropometric data, blood pressure, body mass index (BMI), waist circumference (WC) and the following serum markers were analyzed: glucose, Total-c, TGs, LDL-c, Oxidized-LDL, total HDL-c and large and small HDL-c subpopulations, paraoxonase 1 activity, hsCRP, uric acid, TNF-α, adiponectin and VEGF.

Results

Non-diabetic women, compared to men, presented lower glycemia, WC, small HDL-c, uric acid, TNF-α and increased large HDL-c. Diabetes abrogates the protective effect of female gender, since diabetic women showed increased BMI, WC, small HDL-c, VEGF, uric acid, TNF-α and hsCRP, as well as reduced adiponectin, when compared with non-diabetic. In diabetic females, but not in males, WC is directly and significantly associated with TNF-α, VEGF, hsCRP and uric acid; TNF-α is directly associated with VEGF and hsCRP, and inversely with adiponectin. Postmenopausal females presented a worsen cardiometabolic profile, viewed by the increased WC, small HDL-c, VEGF, uric acid, TNF-α and hsCRP. In this population, WC is directly and significantly associated with TNF-α, VEGF, hsCRP; TNF-α is directly associated with VEGF; and uric acid is inversely associated with large HDL-c and hsCRP with adiponectin, also inversely.

Conclusions

Diabetes abrogates the protective effect of gender on non-diabetic women, and postmenopausal diabetic females presented worsen cardiometabolic risk, including a more atherogenic lipid sketch and a pro-inflammatory and pro-angiogenic profile. The classical cardiovascular risk factors (CVRFs) fail to completely explain these differences, which are better clarified using “non-traditional” factors, such as HDL-c subpopulations, rather than total HDL-c content, and markers of inflammation and angiogenesis, namely TNF-α, hsCRP, uric acid and VEGF. Multi-therapeutic intervention, directed to obesity, atherogenic lipid particles and inflammatory mediators is advisory in order to efficiently prevent the serious diabetic cardiovascular complications.

Keywords:
Diabetes; Gender; HDL-c subpopulations; Markers of cardiovascular risk; Menopause