Effect Of Gender On Responsiveness Of Multiple Cardiovascular Disease Risk Factors To Lifestyle Health Coaching In Adults With Prediabetes

Abstract

Prediabetes affects ∼33.5% of men and ∼22.6% of women in the U.S. Scarce data are available on the effect of gender on the responsiveness of cardiovascular disease (CVD) risk factors to lifestyle health coaching (LHC) in adults with prediabetes. PURPOSE: In this study of 967 men (n = 399; age = 57 years) and women (n = 568; age = 55 years) with prediabetes, we evaluated the effect of gender on the responsiveness of multiple CVD risk factors to LHC. METHODS: At baseline, all participants met the American Diabetes Association's (ADA) criteria for prediabetes. Participants were evaluated at baseline and after an average of ∼4 months of LHC. LHC included individualized coaching on exercise, nutrition, weight management, and smoking cessation. RESULTS: In men, baseline fasting glucose (108 mg/dl) decreased by 5 mg/dl (p <0.05) with LHC. Similarly, baseline fasting glucose (107 mg/dl) decreased by 5 mg/dl (p <0.05) with LHC in women. Based on ADA criteria, 172 (43.1%) men and 250 (44.0%) women normalized their fasting glucose (i.e., fasting glucose below 100 mg/dl). For participants with abnormal baseline risk factors, significant (p <0.05) improvements were observed for multiple additional variables, as follows: blood pressure (Men, -9/7 mmHg; Women, -9/7 mmHg); LDL cholesterol (Men, -25 mg/dl; Women, -15 mg/dl; p <0.05 for Men versus Women); HDL cholesterol (Men, 2 mg/dl; Women, 3 mg/dl); triglycerides (Men, -56 mg/dl; Women, -35 mg/dl; p <0.05 for Men versus Women); and weight (Men, -8 lbs; Women, -7 lbs). Of the participants who smoked cigarettes at baseline, 19.6% of men and 0% of women quit smoking. In participants with a baseline Framingham 10-year coronary heart disease risk score >10%, the score decreased significantly (p <0.05) in men and women (Men, -22.8%; Women, -18.1%; p <0.05 for Men versus Women). Thus, while the magnitude of reduction in fasting glucose was similar in men and women, men derived a slightly greater benefit in terms of overall CVD risk reduction. CONCLUSIONS: The present study adds to previous research by reporting on the effectiveness (rather than the efficacy) of LHC in adults with prediabetes. The data show that many adults with prediabetes can normalize their fasting glucose with LHC but suggest that there may be gender-related differences in the therapeutic responsiveness of certain risk factors.