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Severity of coronary artery disease in postmenopausal diabetic women
Katerina Saltiki1, Adrianna Cimponeriu, Kyriaki Lili
1Endocrine Unit, Evgenidion Hospital and Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece. saze@otenet.gr
Insights
Diabetic postmenopausal women have significantly more severe coronary artery disease (CAD) than non-diabetic women. Type 2 diabetes mellitus (T2DM) is an independent predictor of advanced CAD in this population.
Area of Science:
- Cardiology
- Endocrinology
- Women's Health
Background:
- Coronary artery disease (CAD) risk is elevated in postmenopausal women.
- Diabetes is a known risk factor for cardiovascular disease.
Purpose of the Study:
- To investigate the impact of diabetes on the severity of CAD in postmenopausal women.
- To assess the relationship between type 2 diabetes mellitus (T2DM) and coronary atherosclerosis.
Main Methods:
- Coronary angiography was performed on 180 postmenopausal women with suspected CAD.
- CAD severity was quantified by the number of stenosed coronary arteries.
- Clinical, biochemical, and hormonal data were collected, including T2DM status.
Main Results:
- Diabetic women (n=44) exhibited a significantly higher prevalence of severe CAD (≥3 vessel disease) compared to non-diabetic women (p<0.001).
- T2DM was an independent predictor of severe CAD, even after adjusting for age, BMI, hypertension, and hypercholesterolemia.
- Diabetic women had lower sex hormone-binding globulin (SHBG) levels.
Conclusions:
- Type 2 diabetes mellitus is associated with more severe coronary artery disease in postmenopausal women.
- The findings suggest an independent role of T2DM in accelerating atherosclerosis in this demographic.
- Further research into the mechanisms underlying this association is warranted.
Objective:
Coronary artery disease (CAD) risk increases in women after the menopause. The aim of this study was to determine the effect of diabetes on the severity of CAD in postmenopausal women undergoing coronary angiography.
Design:
180 postmenopausal women underwent coronary angiography for suspected CAD. CAD severity was assessed by the number of arteries (0-3) with >50% stenosis in the angiography. Forty-four women had type 2 diabetes mellitus (T2DM). Predisposing risk factors and biochemical and hormonal parameters were recorded. The diabetic women were older (p=0.014), had higher BMI and waist circumference (p<0.001), higher prevalence of hypertension (p=0.002), higher levels of triglycerides, uric acid and higher HOMA-Insulin Resistance Index (p=0.009).
Results:
The women with diabetes had a higher prevalence of severe stenosis in the angiography: T2DM: 0-vessels 25%, 1-vessel disease 18.2%, 2-vessels disease 22.7%, 3-vessels disease 34.1%, vs. 49.2%, 23.5%, 22.1%, 5.1% in the non-diabetic women, respectively (p<0.001). Binary logistic regression analysis showed that T2DM was a significant predictor of severe CAD (>or=3 vessel disease) independently of age, family history of T2DM, BMI, time since menopause, hypertension and hypercholesterolemia. Women with T2DM also had lower sex hormone binding globulin (SHBG, p=0.010) levels compared to non-diabetic women.
Conclusions:
Diabetic postmenopausal women develop more severe CAD compared to non-diabetic women. This association is independent of other predisposing factors and suggests an independent effect of T2DM on the atherosclerotic process, at least in women after menopause.
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