Author + information
- Received February 28, 2000
- Revision received June 2, 2000
- Accepted July 14, 2000
- Published online December 1, 2000.
- Helen M Colhoun, MFPHM∗,* (, )
- Michael B Rubens, FRCR†,
- S.Richard Underwood, MD, FRCP† and
- John H Fuller, FRCP∗
- ↵*Reprint requests and correspondence: Dr. Helen M. Colhoun, EURODIAB, Department of Epidemiology and Public Health, University College London Medical School, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
To examine whether the gender difference in coronary artery calcification, a measure of atherosclerotic plaque burden, is lost in type 1 diabetic patients, and whether abnormalities in established coronary heart disease risk factors explain this.
Type 1 diabetes abolishes the gender difference in coronary heart disease mortality because it is associated with a greater elevation of coronary disease risk in women than men. The pathophysiological basis of this is not understood.
Coronary artery calcification and coronary risk factors were compared in 199 type 1 diabetic patients and 201 nondiabetic participants of similar age (30 to 55 years) and gender (50% female) distribution. Only one subject had a history of coronary disease. Calcification was measured with electron beam computed tomography.
In nondiabetic participants there was a large gender difference in calcification prevalence (men 54%, women 21%, odds ratio 4.5, p < 0.001), half of which was explained by established risk factors (odds ratio after adjustment = 2.2). Diabetes was associated with a greatly increased prevalence of calcification in women (47%), but not men (52%), so that the gender difference in calcification was lost (p = 0.002 for the greater effect of diabetes on calcification in women than men). On adjustment for risk factors, diabetes remained associated with a threefold higher odds ratio of calcification in women than men (p = 0.02).
In type 1 diabetes coronary artery calcification is greatly increased in women and the gender difference in calcification is lost. Little of this is explained by known coronary risk factors.
☆ This study was supported by the British Heart Foundation, London, United Kingdom.
- Received February 28, 2000.
- Revision received June 2, 2000.
- Accepted July 14, 2000.
- American College of Cardiology