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- Title
Effect of type 1 diabetes on the gender difference in coronary artery calcification: a role for insulin resistance? The Coronary Artery Calcification in Type 1 Diabetes (CACTI) Study.
- Authors
Dabelea D; Kinney G; Snell-Bergeon JK; Hokanson JE; Eckel RH; Ehrlich J; Garg S; Hamman RF; Rewers M; Dabelea, Dana; Kinney, Gregory; Snell-Bergeon, Janet K; Hokanson, John E; Eckel, Robert H; Ehrlich, James; Garg, Satish; Hamman, Richard F; Rewers, Marian; Coronary Artery Calcification in Type 1 Diabetes Study
- Abstract
The objective of this is study was to examine whether estimated insulin resistance and insulin resistance-related factors are associated with coronary artery calcification (CAC) in 1,420 asymptomatic participants in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study. A total of 656 patients with type 1 diabetes and 764 control subjects aged 20-55 years were examined. CAC was assessed by electron-beam computed tomography. Insulin resistance was computed with linear regression based on an equation previously validated in clamp studies on type 1 diabetic adults. Insulin resistance was associated with CAC (OR 1.6 in type 1 diabetes and 1.4 in control subjects, P < 0.001), independent of coronary artery disease risk factors. There was a male excess of CAC in control subjects (OR 2.7, adjusted for age, smoking, and LDL and HDL cholesterol levels) and in type 1 diabetic patients (OR 2.2, adjusted for the same factors and diabetes duration). After adjusting for insulin resistance, the CAC male excess in diabetic patients decreased from OR 2.2 (P < 0.001) to 1.8 (P = 0.04). After adjustment for waist-to-hip ratio, waist circumference, or visceral fat, the gender difference in CAC was not significant in diabetic subjects. In conclusion, gender differences in insulin resistance-associated fat distribution may explain why type 1 diabetes increases coronary calcification in women relatively more than in men.
- Publication
Diabetes, 2003, Vol 52, Issue 11, p2833
- ISSN
0012-1797
- Publication type
journal article
- DOI
10.2337/diabetes.52.11.2833