Established and novel gender dimorphisms in type 2 diabetes mellitus: Insights from a multiethnic cohort.

Hermans, Michel;Ahn, Sylvie;Sadikot, Shaukat;Rousseau, Michel
(2021) Diabetes & Metabolic Syndrome : clinical research & reviews — Vol. 14, n° 5, p. 1503-1509 (2021)

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Authors
  • Hermans, MichelUCLouvain
    Author
  • Ahn, SylvieUCLouvain
    Author
  • Sadikot, Shaukat
    Author
  • Rousseau, MichelUCLouvain
    Author
Abstract
BACKGROUND AND AIMS: In type 2 diabetes mellitus (T2DM), sexual dimorphisms modulate the natural histories of hyperglycemia, anthropophysical/cardiometabolic phenotype, and susceptibility to chronic micro and macrovascular complications. The purpose of this work was to revisit known or new dimorphisms within a multiethnic cohort. METHODS: Among 1238 T2DM patients, men (63%) were compared to women (37%), including leading ethnicities: Whites (67.4%; 542 men; 293 women); Maghrebians (9.4%; 62 men; 54 women); and Blacks (12.5%; 92 men; 63 women). RESULTS: Age, BMI, diabetes duration, insulin sensitivity, B-cell function loss, HbA1c, and hyperglycemia index were similar in both genders. All-cause microangiopathy and cerebrovascular disease did not differ between sexes. Women had significantly more retinopathy (27% vs. 21%) and men more microalbuminuria (25% vs. 19%), all-cause macroangiopathy (40% vs. 26%), CAD (29% vs. 17%) and PAD (11% vs. 6%). Among Blacks, sexual dimorphism in terms of retinopathy was more pronounced (24% in women vs. 11%), while there was no sexual dimorphism in all-cause macroangiopathy, CAD or PAD. B-cell function loss was faster among North African men (+15%), who also had more hepatic steatosis (+27%) than women. CONCLUSIONS: T2DM abolishes the CV protection provided by the female gender in Blacks. In White women, the loss of CV protection in diabetes is limited to cerebrovascular disease. In Black women, a markedly increased risk of retinopathy is present, despite glycemic exposure similat to men. Sexual dimorphisms do not affect glucose homeostasis and metabolic control in all ethnicities, except for lesser B-cell function loss in Maghrebian women.
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Hermans, M., Ahn, S., Sadikot, S., & Rousseau, M. (2021). Established and novel gender dimorphisms in type 2 diabetes mellitus: Insights from a multiethnic cohort. Diabetes & Metabolic Syndrome : clinical research & reviews, 14(5), 1503-1509. https://doi.org/10.1016/j.dsx.2020.07.027 (Original work published 2021)