Women with type 2 diabetes have LDL cholesterol levels higher than those of men, regardless of their treatment and their cardiovascular risk level

Several works have shown that control of the principal cardiovascular risk factors, especially LDL-C, is poorer among women with type 2 diabetes than men with this disease. Our objectives were to compare the statin treatments and LDL-C levels between men and women with type 2 diabetes, according to...

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Published in:Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2023-06, Vol.33 (6), p.1254-1262
Main Authors: Paquet, Sylvain, Sassenou, Jeanne, Ringa, Virginie, Czernichow, Sébastien, Zins, Marie, Ozguler, Anna, Rigal, Laurent
Format: Article
Language:English
Subjects:
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cholesterol
Cholesterol, LDL
Cross-Sectional Studies
Diabetes mellitus
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - epidemiology
Female
Gender
Heart Disease Risk Factors
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects
Life Sciences
Lipid lowering treatment
Male
Risk Factors
Statins
Treatment Outcome
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Summary:Several works have shown that control of the principal cardiovascular risk factors, especially LDL-C, is poorer among women with type 2 diabetes than men with this disease. Our objectives were to compare the statin treatments and LDL-C levels between men and women with type 2 diabetes, according to the potency of the statin they take, while taking their cardiovascular risk level into account. This is a descriptive cross-sectional study within the French CONSTANCES cohort. At inclusion, each individual completed several self-administered questionnaires. Data were then matched to their health insurance fund reimbursement data. The study population comprises cohort members with pharmacologically treated type 2 diabetes. We identified 2541 individuals with type 2 diabetes; 2214 had an available LDL-C value. In the total sample, treatment by statins did not differ between men and women, while the women had a higher mean LCL-C level than men. The analyses stratified by cardiovascular risk showed that women at very high cardiovascular risk received significantly less frequent statin delivery than men (OR = 0.72 [0.56–0.92]; p = 0.01). At the same time, women received the same rate of high-potency statins as men. Women taking equivalently potent statins had significantly higher LDL-C levels than men did. For the same cardiovascular risk level and the same statin treatment, women had an LDL-C level higher than that of men. They thus present a residual cardiovascular risk that justifies intensification of their statin treatment if tolerance allows. •Women with diabetes mellitus have consistently higher LDL-C than men including women at very high cardiovascular risk.•For the same statin potency, diabetic women always have higher LDL-C than diabetic men.•Because of the higher LDL-C, diabetic women have an excess cardiovascular risk compared to diabetic men.•Because of this increased cardiovascular risk, women with diabetes should be given increased statin therapy if tolerated.
ISSN:0939-4753
1590-3729
DOI:10.1016/j.numecd.2023.03.015