This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Goldschmid, M. G. Articles by Herman, W. H. Search for Related Content PubMed PubMed Citation Articles by Goldschmid, M. G. Articles by Herman, W. H.

Circulation, Vol 89, 991-997, Copyright © 1994 by American Heart Association

ARTICLES

Dyslipidemia and ischemic heart disease mortality among men and women with diabetes

MG Goldschmid, E Barrett-Connor, SL Edelstein, DL Wingard, BA Cohn and WH Herman
Division of Diabetes Translation, Centers for Disease Control, Atlanta, GA.

BACKGROUND: We investigated whether the greater increased risk of ischemic heart disease mortality associated with diabetes among women compared with men could be explained by their more pronounced lipoprotein abnormalities. METHODS AND RESULTS: Seventy-six men and 45 women with diabetes and 327 men and 496 women without diabetes were followed for an average of 16 years in a population-based study. Cox proportional hazards models were used to determine the relative hazard of ischemic heart disease mortality for changes in lipoprotein subfractions after adjustment for age, hypertension, obesity, smoking, exercise, alcohol consumption, and estrogen use (among women). The relative hazard of ischemic heart disease mortality among diabetic women was 1.76 (P = .10) for a 10-mg/dL decrement in high-density lipoprotein cholesterol (HDL-C) and 3.13 (P = .01) for a 1-U increment in log very-low-density lipoprotein cholesterol (VLDL-C). The risk of ischemic heart disease mortality among diabetic women relative to nondiabetic women for an HDL-C level of 50 mg/dL and a log(e) VLDL-C of 3 (about 20 mg/dL) were 4.1 and 3.4, respectively (P < .05). These lipoprotein changes were not associated with ischemic heart disease mortality among men or among nondiabetic women. CONCLUSIONS: Excess ischemic heart disease mortality among diabetic women is partially explained by deleterious levels of HDL-C and VLDL-C. HDL-C levels of < or = 50 mg/dL and VLDL-C levels of > or = 20 mg/dL appear to predict ischemic heart disease mortality among these women and may help identify women who would benefit most from intervention.

This article has been cited by other articles:

				A. Ferrara, C. M. Mangione, C. Kim, D. G. Marrero, D. Curb, M. Stevens, J. V. Selby, and for the Translating Research Into Action for Diabe Sex Disparities in Control and Treatment of Modifiable Cardiovascular Disease Risk Factors Among Patients With Diabetes: Translating Research Into Action for Diabetes (TRIAD) Study Diabetes Care, January 1, 2008; 31(1): 69 - 74. [Abstract] [Full Text] [PDF]

				A. Ferrara, D. F. Williamson, A. J. Karter, T. J. Thompson, C. Kim, and for the TRIAD Study Group Sex Differences in Quality of Health Care Related to Ischemic Heart Disease Prevention in Patients With Diabetes: The Translating Research Into Action for Diabetes (TRIAD) study, 2000-2001 Diabetes Care, December 1, 2004; 27(12): 2974 - 2976. [Full Text] [PDF]

				A. M. Kanaya, D. Grady, and E. Barrett-Connor Explaining the Sex Difference in Coronary Heart Disease Mortality Among Patients With Type 2 Diabetes Mellitus: A Meta-analysis Arch Intern Med, August 12, 2002; 162(15): 1737 - 1745. [Abstract] [Full Text] [PDF]

				J. E Roeters van Lennep, H.T. Westerveld, D.W. Erkelens, and E. E van der Wall Risk factors for coronary heart disease: implications of gender Cardiovasc Res, February 15, 2002; 53(3): 538 - 549. [Abstract] [Full Text] [PDF]

				F. K. Welty Cardiovascular Disease and Dyslipidemia in Women Arch Intern Med, February 26, 2001; 161(4): 514 - 522. [Abstract] [Full Text] [PDF]

				J. C. LaRosa Triglycerides and Coronary Risk in Women and the Elderly Arch Intern Med, May 12, 1997; 157(9): 961 - 968. [Abstract] [PDF]

				E. Barrett-Connor Sex Differences in Coronary Heart Disease: Why Are Women So Superior? The 1995 Ancel Keys Lecture Circulation, January 7, 1997; 95(1): 252 - 264. [Full Text]

				U. Goldbourt, S. Yaari, and J. H. Medalie Isolated Low HDL Cholesterol As a Risk Factor for Coronary Heart Disease Mortality: A 21-Year Follow-up of 8000 Men Arterioscler Thromb Vasc Biol, January 1, 1997; 17(1): 107 - 113. [Abstract] [Full Text]