Sex Differences in Microvascular Function and Circulating Biomarkers in Patients with Type 2 Diabetes Mellitus

Abstract

Cardiovascular diseases are the major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Evidence has shown that women have a greater risk for cardiovascular complications than men with T2DM, indicating a sex‐gender specific difference. Further studies regarding the mechanisms of sex differences are required for better prevention and treatment of diabetes complications in women. The aim of this study was to examine the microvascular endothelial function and circulating biomarkers in postmenopausal women (50–67 years) and age‐matched men with T2DM, without a history of cardiovascular events or complications. Participants without T2DM were also evaluated as control groups. This study was approved by the Ethical Committee of UNESP and UNICAMP (Number: 1.548.242). The eligible participants composed 4 groups: postmenopausal women (W) (n=16); postmenopausal women with T2DM (DW) (n=15); middle‐aged men (M) (n=15); middle‐aged men with T2DM (DM) (n=14). All participants were physically inactive, non‐smokers and not taking hormonal replacement or on insulin therapy. Both diabetic groups were on oral hypoglycemic therapy. After resting blood pressure measurement, the microvascular endothelial function was performed using EndoPAT 2000 and expressed as the reactive hyperemic index (RHI). Fasting blood samples were collected for biochemical analyses. All groups were age‐matched and the time of T2DM diagnosis was similar between the groups (DW: 7.5±1.3 DM: 9.6±2.3 yrs). Anthropometric parameters, systolic and diastolic blood pressure, lipid profile, HbA1c and insulin levels were not different between women and men with diabetes. On the other hand, DM showed a higher blood glucose level and HOMA‐IR compared with DW. Regarding microvascular endothelial function, RHI was similar between DW (1.97±0.14) and DM (1.93±0.12) without alterations in circulating biomarkers: adiponectin, N‐ɛ‐(carboxymethyl) lysine (CML), nitrite/nitrate (NOx−), transforming growth factor‐β (TGF‐β), tumor necrosis factor‐α (TNF‐α) and C‐reactive protein (CRP). Nevertheless, when diabetic groups were compared with the control groups, we observed a higher body mass index (BMI) and abdominal circumference in DW compared with its respective control group. Besides that, DW also presented impaired RHI and a lower adiponectin level associated with increased CML and NOx− concentrations compared with W group (RHI: 2.51±0.13). All these alterations were not found in DM compared with its respective control group. Our findings show that circulatory biomarkers disturbance and microvascular dysfunction are present in diabetic women showing that this population is more affected by the deleterious effects of T2DM than men.Support or Funding InformationCNPq and FAPESPThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.