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The effect of type 1 diabetes mellitus on the gender difference in coronary artery calcification

H M Colhoun1, M B Rubens, S R Underwood

  • 1Department of Epidemiology and Public Health, Royal Free and University College London Medical School, United Kingdom. helen@public-health.ucl.ac.uk

Journal of the American College of Cardiology
|December 29, 2000
PubMed

Insights

Type 1 diabetes increases coronary artery calcification in women, erasing the typical gender difference. This change is not explained by common coronary heart disease risk factors.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Type 1 diabetes eliminates the gender gap in coronary heart disease mortality.
  • This occurs due to a disproportionately higher increase in coronary disease risk for women with type 1 diabetes compared to men.
  • The underlying physiological reasons for this phenomenon remain unclear.

Purpose of the Study:

  • To investigate if type 1 diabetes eliminates the gender disparity in coronary artery calcification.
  • To determine if established coronary heart disease risk factors account for any observed gender differences in calcification within type 1 diabetic individuals.

Main Methods:

  • A comparative study involving 199 individuals with type 1 diabetes and 201 non-diabetic controls.
  • Participants were aged 30-55 years with an equal gender distribution (50% female).
  • Coronary artery calcification was quantified using electron beam computed tomography; various coronary risk factors were assessed.

Main Results:

  • In non-diabetic individuals, men exhibited significantly higher coronary calcification prevalence (54%) than women (21%), a difference partially explained by risk factors.
  • Type 1 diabetes substantially increased calcification in women (47%) but not in men (52%), thus eliminating the gender difference (p=0.002).
  • Even after adjusting for risk factors, type 1 diabetes was associated with a threefold higher odds of calcification in women compared to men (p=0.02).

Conclusions:

  • Type 1 diabetes leads to a significant increase in coronary artery calcification among women.
  • The presence of type 1 diabetes results in the loss of the typical gender difference in coronary artery calcification.
  • Known coronary heart disease risk factors do not substantially explain this observed gender-specific increase in calcification in type 1 diabetes.
Abstract

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