Persistent Sex Differences in Cardiovascular Disease Risk Factors: A Longitudinal Cohort Study in Youth With Type 1 Diabetes.

Abstract

Women with type 1 diabetes experience a greater diabetes-related increase in cardiovascular disease and mortality risk than men. This study aims to examine early sex-related differences in cardiovascular disease risk factors among youths with type 1 diabetes. This study included 311 Slovenian participants aged 2-25 years who were enrolled between 2015 and 2016 (50.8% female; mean age=12.66±4.32 years; diabetes duration, 5.77±3.77 years), were clinically diagnosed with type 1 diabetes for at least 1 year, and underwent annual assessments. A linear mixed model was used to analyze associations over a mean follow-up of 3.91±1.72 years. Females had persistently higher-risk lipid profiles with higher total cholesterol, low-density lipoprotein cholesterol, nonhigh-density lipoprotein cholesterol, and apolipoprotein B levels (p<0.001); higher high-sensitivity C-reactive protein levels (p=0.023); and greater multifactorial cardiovascular disease risk (p=0.04). High low-density lipoprotein cholesterol and BMI and low low-density lipoprotein/apolipoprotein B ratios were linked to increased high-sensitivity C-reactive protein, whereas high insulin pump/sensor use was associated with decreased high-sensitivity C-reactive protein (p=0.008). Females exhibited persistently higher inflammation, likely influenced by an unfavorable lipid profile and multiple cardiovascular disease risk factors, highlighting the need for early, sex-specific cardiovascular disease risk reduction strategies. Further research is needed to assess the long-term impact of these interventions.