Sex-specific differences in blood lipids and lipid ratios in type 2 diabetic foot patients

J Diabetes Investig. 2021 Dec;12(12):2203-2211. doi: 10.1111/jdi.13615. Epub 2021 Jul 17.

Abstract

Aims/introduction: Few people have reported whether there are sex differences in blood lipids and lipid ratios in type 2 diabetic foot (T2DF) patients in China. This study attempts to identify the contribution to sex-specific differences in blood lipids and lipid ratios in these patients.

Materials and methods: In this case-control study, we explore 306 patients with T2DF as the study group and 306 patients with type 2 diabetes mellitus as the control group. Patients were diagnosed according to the Standards of Medical Care in Diabetes-2014 (American Diabetes Association). Blood lipid and lipid ratios were determined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.

Results: We studied male patients with T2DF who were aged 68.00 years (18.00 years) and females who were aged 73.50 years (19.00 years); 61.76% of the patients were men. Men had higher body mass index and glycated hemoglobin levels than women. Compared with type 2 diabetes mellitus patients, T2DF patients had significant differences in total cholesterol/high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol/HDL-C and apolipoprotein (apo)B/apoA-I ratios. HDL-C, triglyceride, apoA-I and apoB/apoA-I ratio showed cardiovascular disease risk in men, whereas total cholesterol, low-density lipoprotein cholesterol, apoB, and the low-density lipoprotein cholesterol/HDL-C and total cholesterol/HDL-C ratios were better predictors in women. The apoB/apoA-I ratio odds ratio values were 2.18 (95% confidence interval 1.17-4.41) and 2.14 (95% confidence interval 1.14-4.00) in male patients with T2DF before and after adjusting for age, respectively (P < 0.05).

Conclusions: T2DF patients present sex-specific differences in their blood lipid and lipid ratios, especially in the apoB/apoA-I ratio, which could be a better indicator for cardiovascular disease risk.

Keywords: Blood lipids and lipid ratios; Diabetic foot; Sex differences.

MeSH terms

  • Aged
  • Apolipoprotein A-I / blood
  • Apolipoprotein B-100 / blood
  • Body Mass Index
  • Case-Control Studies
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Foot / blood*
  • Diabetic Foot / etiology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Lipids / blood*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Factors*

Substances

  • Apolipoprotein A-I
  • Apolipoprotein B-100
  • Cholesterol
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin
  • Lipids
  • APOA1 protein, human
  • APOB protein, human
  • hemoglobin A1c protein, human