Gender differences in cardiovascular risk factors in adults with type 1 diabetes in France (SFDT1) and Germany (DPV)

Objective: To compare cardiovascular risk factors between adult men and women with type 1 diabetes (T1D) in primary prevention in two European countries.

Methods: Data were collected in 2020-2022 from the SFDT1 study in France (90% university hospital) and from the DPV-Registry in Germany (centers with more than 100 patients). We included patients aged 18-50 years with T1D, diagnosed between 6 months and<35 years of age, and without previous cardiovascular disease (CVD).

Results: After exclusion of 23/950 (2.4%) with previous CVD in France (F) and 95/1,490 (6.4%) in Germany (G), we included 918 adults, 53.3% men, mean age: 33.1 years (F), and 1,395 adults, 50.6% men, mean age: 33.6 years (G) respectively. Mean age was similar between men and women, but women had a slight longer diabetes duration (difference significant only in Germany: F: [mean ±SD] 18.1±4.2 vs.16.8±3.4 years, p=0.06; G: 18.7 ±10.5 vs. 16.4±10.5 years, p<0.01) and more often obesity (difference significant only in France: F: 18.2% vs. 13.0%, p=0.04; G: 24.1% vs. 20.5%, p=0.11). In both countries, women used more frequently an insulin pump than men (F: 60.3% vs. 36.3%, p<0.01, G: 41.9% vs. 26.5%, p<0.01). In Germany, men had a higher HbA1c (8.0±1.7% vs. 7.7±1.6%, p=0.02) and a lower TiR (62.2% vs. 66.1%, p=0.02) than women, but not in France (HbA1c: 7.9±1.9% vs. 7.9±1.7%, p=0.64; TiR: 56.4% vs. 55.1%, p=0.77). In both cohorts, hypertension (SBP ≥ 140 or DBP ≥ 90 or antihypertensive medication), dyslipidemia (LDL cholesterol ≥ 3.4 mmol/L) and smoking were more frequent in men than in women (hypertension: F: 14.3% vs. 8.1%, p<0.01; G: 32.7% vs. 23.3%, p<0.01; dyslipidemia, difference only significant in Germany, F: 20.7% vs. 16.8%, p=0.20; G: 22.8% vs.17.6%, p=0.01; smoking: F: 28.8% vs. 20.7%, p<0.01; G: 27.6% vs. 21.90%, p=0.02). No gender differences were observed in the proportion of neuropathy, nephropathy, albuminuria or retinopathy.

Conclusion: In France and Germany, gender differences in cardiovascular risk factors were observed in primary prevention among individuals with T1D aged 18-50 years. Compared to women, men were less often obese, but had more often hypertension, dyslipidemia, and were more frequently smokers. Moreover, men had higher HbA1c and lower TiR than women in Germany.

 

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Artikel online veröffentlicht:
18. April 2024