(P-008) Sex Differences in Lipid Profile Across the Life Span in Patients with Type 2 Diabetes: A Cross-sectional Study

Background: In healthy women, the lipid profile becomes more atherogenic after menopause. Having type 2 diabetes (T2D) increases the risk of cardiovascular disease more in women than in men but it is not clear to what extent this may be related to sex differences in lipid levels across the life span. Also, the influence of statin treatment on possible sex differences is unknown.

Objectives: To assess sex differences in the lipid profile of T2D patients across the life span in those treated and not treated with statins.

Methods: In this cross-sectional study we used the Groningen Initiative to Analyze Type-2 diabetes Treatment (GIANTT) database, which includes data of primary care patients with T2D from the north of the Netherlands. Adult patients with a total cholesterol, low-density cholesterol (LDL-c), high-density cholesterol (HDL-c) and triglyceride (TG) measurement between 2010 and 2012 were included. We excluded patients treated with other lipid lowering drugs than statins. The primary outcomes were LDL-c, HDL-c, and TG levels in mmol/L. A linear regression analysis was conducted per outcome stratified by statin treatment (yes/no). These analyses included the patients’ sex, age (11 age groups) and the interaction between sex and age and were adjusted for body mass index and glycated hemoglobin A1c.

Results: We included 26,849 patients (51% women, 55% treated with statins). In those not treated with statins, women had significantly lower LDL-c levels than men before the age of 45 (3.1 vs. 3.3-3.4, p<0.040), similar levels between ages 45-49 (3.3, p=0.701) and higher levels after the age of 50 (3.2-3.6 vs. 2.9-3.4; p<0.013). In those treated with statins, similar LDL-c levels were shown up to the age of 55 (2.4 vs. 2.3-2.4, p>0.533) and higher levels in women up to the age of 85 (2.2-2.4 vs. 2.0-2.3, p<0.005). Women had significantly higher HDL-c levels than men regardless of age or statin treatment (1.2-1.4 vs. 1.0-1.2, p≤0.001). Men had significantly higher TG levels up to the age of 55 (2.3-2.5 vs. 1.7-1.9, p<0.001) and 60 (1.9-2.4 vs. 1.7-1.8, p<0.007) in those not treated and treated with statins, respectively, and similar levels thereafter (1.6-2.0 vs. 1.6-1.8, p>0.067).

Conclusions: Statin treatment partially lowered the observed sex differences in lipid profiles among T2D patients, but more attention is needed to lower LDL-c in postmenopausal women and TG in younger men.