Cardiovascular Disease in Type 2 Diabetes: A Review of Sex-Related Differences in Predisposition and Prevention
Open accessAbstract
Type 2 diabetes mellitus is a major risk factor for cardiovascular disease. However, compiled data suggest that type 2 diabetes affects the risk of cardiovascular disease differentially according to sex. In recent years, large meta-analyses have confirmed that women with type 2 diabetes have a higher relative risk of incident coronary heart disease, fatal coronary heart disease, and stroke compared with their male counterparts. The reasons for these disparities are not completely elucidated. A greater burden of cardiometabolic risk in women was proposed as a partial explanation. Indeed, several studies suggest that women experience a larger deterioration in major cardiovascular risk factors and put on more weight than do men during their transition from normoglycemia to overt type 2 diabetes. This excess weight is associated with higher levels of biomarkers of endothelial dysfunction, inflammation, and procoagulant state. Moreover, sex differences in the prescription and use of some cardiovascular drugs may compound an "existing" disparity. We searched PubMed for articles published in English and French, by using the following terms: ("cardiovascular diseases") AND ("diabetes mellitus") AND ("sex disparity" OR "sex differences" OR "sex related differences" OR "sex-related differences" OR "sex disparities"). In this article, we review the available literature on the sex aspects of primary and secondary prevention of cardiovascular disease in people with type 2 diabetes, in the predisposition to cardiovascular disease in those people, and in the control of diabetes and associated cardiovascular risk factors.
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A sensitivity analysis for the effect of treatment on ratios-to-baseline by sex was conducted to account for potential sex-related differences on the inflammatory response.
“to account for potential sex-related differences on the inflammatory response [25], a sensitivity analysis for the effect of treatment (semaglutide or comparator) on ratios-to-baseline by sex (male/female) at baseline was also conducted.”
From Impact of semaglutide on high-sensitivity C-reactive protein: exploratory patient-level analyses of SUSTAIN and PIONEER randomized clinical trials (2022) · cites this paper as [25]
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Gender Differences in Cardiovascular Risk Factors in Incident Diabetes
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Cited by
Sorted by citations
Singh, A. K., & Singh, R. (2020) · Diabetes & Metabolic Syndrome: Clinical Research & Reviews · doi:10.1016/j.dsx.2020.02.012 · Cited by 114 · see citing works
Mosenzon, O., Capehorn, M. S., De Remigis, A., Rasmussen, S., Weimers, P., & Rosenstock, J. (2022) · Cardiovascular Diabetology · doi:10.1186/s12933-022-01585-7 · Cited by 91 · see citing works
- Authors
- Al-Salameh, A., Chanson, P., Bucher, S., Ringa, V., & Becquemont, L.
- Affiliations
- Université Paris-Sud (FR)
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 94
- Issue
- 2
- Pages
- 287-308
- ISSN
- 0025-6196 (ISSN-L)
- OpenAlex
- W2912946077
- Cited by
- 77
- References
- 99
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 4 · 2023: 15 · 2022: 19 · 2021: 13 · 2020: 7 · 2019: 4
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Mayo Clinic Proceedings (acceptedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, cardiovascular disease, sex differences, sex disparities, coronary artery disease, stroke, cardiometabolic risk, endothelial dysfunction, inflammation, procoagulant state, weight gain, cardiovascular risk factors, cardiovascular drug use, primary prevention, secondary prevention
- MeSH terms
- Healthy Lifestyle, Cardiovascular Agents, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Primary Prevention, Risk Factors, Sex Factors, Global Health, Incidence, Secondary Prevention
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