INFLUENCE OF GENDER ON THE RELATIONSHIP BETWEEN FASTING INSULIN AND CARDIOVASCULAR RISK-FACTORS IN TYPE-II DIABETIC-PATIENTS

The aim of this study was to evaluate the influence of gender and hype rinsulinaemia on accelerated atherogenesis in Type II diabetic subject s, Both the cardiovascular risk factor profile and the prevalence of c oronary heart disease (CHD) were investigated in 106 men and 91 women with Type II diabetes. The two groups were considered separately and w ere further divided by insulin levels, lower and higher than 15 mU/ml, Women with higher insulin levels differed from those with lower insul in concentrations only in increased BMI and triglyceride levels, where as hyperinsulinaemic men differed from normoinsulinaemic ones also wit h respect higher HbA(1c), increased systolic blood pressure levels and lower HDL cholesterol concentrations. Moreover, Type II diabetic pati ents with CHD differed from those without CHD in higher insulin levels independently of sex, men with CHD differed also in higher concentrat ions of triglycerides, cholesterol and HbA(1c), lower levels of HDL ch olesterol and higher prevalence of hypertension, whereas women with CH D differed only in HbA(1c) levels. The two sexes did not differ signif icantly in absolute prevalence of hypertension and CHD, but hyperinsul inaemic men showed a prevalence of CHD 7 times as high as those with n ormal insulin levels (56% vs 8%), whereas hyperinsulinaemic women show ed a CHD prevalence only 2.2 times as high as did normoinsulinaemic wo men (40% vs 16%), Interestingly, normoinsulinaemic women had a signifi cantly (p < 0.001) higher (18%) CHD prevalence than normoinsulinaemic men (8%), This study suggests that, although the prevalence of CHD and hypertension is comparable in Type II diabetic men and women, the adv erse influence of hyperinsulinaemia on the profile of risk factors for cardiovascular disease seems to be more markedly expressed in men.