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Persistent Sex Differences in Cardiovascular Disease Risk Factors: A Longitudinal Cohort Study in Youth With Type 1
Darja Šmigoc Schweiger1, Zala Mlinarič1, Maddalena Macedoni2
1Department of Endocrinology, Diabetes, and Metabolic Diseases, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
American Journal of Preventive Medicine
|April 23, 2026
Summary
Young females with type 1 diabetes (T1D) show higher cardiovascular disease (CVD) risk factors, including unfavorable lipid profiles and inflammation. Early, sex-specific strategies are needed to mitigate these risks in T1D youth.
Area of Science:
- Cardiology
- Endocrinology
- Pediatrics
Background:
- Type 1 diabetes (T1D) increases cardiovascular disease (CVD) and mortality risk, with women facing higher risks than men.
- Early identification of sex-related differences in CVD risk factors among youth with T1D is crucial.
Purpose of the Study:
- To investigate sex-based disparities in cardiovascular disease (CVD) risk factors in pediatric and adolescent populations with type 1 diabetes (T1D).
Main Methods:
- A cohort of 311 Slovenian participants (aged 2-25 years) with T1D were followed for approximately 4 years.
- Linear mixed models were employed to analyze longitudinal changes in CVD risk factors, considering sex as a variable.
Main Results:
- Females consistently displayed higher levels of total cholesterol, LDL-C, non-HDL-C, ApoB, and hsCRP, indicating an unfavorable lipid profile and increased inflammation.
- Multifactorial CVD risk was significantly greater in females compared to males.
- High LDL-C, BMI, and low LDL/ApoB ratios correlated with elevated hsCRP, while insulin pump/sensor use was linked to reduced hsCRP.
Conclusions:
- Females with T1D exhibit persistent inflammation, likely driven by adverse lipid profiles and multiple CVD risk factors.
- These findings underscore the necessity for developing and implementing sex-specific CVD risk reduction strategies in young individuals with T1D.
- Further research is warranted to evaluate the long-term efficacy of these tailored interventions.
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