Key result
Female outpatients with type 2 diabetes and coronary heart disease were significantly less likely to achieve the LDL-C goal of <1.8 mmol/L compared to men (13.5% vs. 20.4%, OR 0.61).
Why the study?
Does female gender reduce the likelihood of lipid goal attainment in type 2 diabetes outpatients with coronary heart disease?
Cross-Sectional (n=3,793)
Yes
Does female gender reduce the likelihood of lipid goal attainment in type 2 diabetes outpatients with coronary heart disease?
Odds Ratio: 0.61 (95% CI 0.52–0.73)
Absolute Event Rate: 13.5% vs 20.4%
p-value: p=<0.001
Women with type 2 diabetes and coronary heart disease are significantly less likely to receive lipid-lowering therapy and achieve LDL-C goals compared to men, highlighting a critical gender disparity in cardiovascular risk management.
May indicate sex disparities in lipid control for T2D with CHD; hypothesis-generating and should not yet change practice.
Our study was aimed to investigate the gender disparities in lipid goal attainment among type 2 diabetes outpatients with concomitant coronary heart disease (CHD) and explore potential risk factors. We performed the present analysis using data from a nationally representative epidemiologic study. The therapeutic goal was defined as achieving a low-density lipoprotein cholesterol (LDL-C) <1.8 mmol/L. A total of 1721 male and 2072 female type 2 diabetes outpatients with established CHD were identified. Compared with men, women had higher levels of total cholesterol (4.98 vs. 4.46 mmol/L; p < 0.001), LDL-C (2.82 vs. 2.54 mmol/L; p < 0.001), and triglycerides (2.02 vs. 1.79 mmol/L; p < 0.001), but not hemoglobin A1c (7.47% vs. 7.50%; p = 0.597). The proportion of women received lipid-lowering therapy was lower (38.1% vs. 48.2%; p < 0.001). The percentages of patients who achieved the LDL-C goal were higher among men. Multivariable regression analysis indicated that the odds ratio for lipid goal attainment due to the gender difference was 0.61 after adjusting confounders. The inability to achieve LDL-C goals in women with type 2 diabetes and CHD is apparently greater than that in men. This finding underscores the importance of initiatives to establish a more aggressive lipid management strategy for women to overcome gender imbalances.
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Zhang et al. (2017) conducted a cross-sectional in Type 2 diabetes with concomitant coronary heart disease (n=3,793). Female gender vs. Male gender was evaluated on LDL-C goal attainment (<1.8 mmol/L) (OR 0.61, 95% CI 0.52-0.73, p=<0.001). Female outpatients with type 2 diabetes and coronary heart disease were significantly less likely to achieve the LDL-C goal of <1.8 mmol/L compared to men (13.5% vs. 20.4%, OR 0.61).
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