Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
Authors' conclusion
Menopause in women with type 1 diabetes is accompanied by an increase in the prevalence of asymptomatic cardioautonomic neuropathy. This age-related excess risk of cardioautonomic neuropathy is not observed in men. Men and women with type 1 diabetes have opposite associations between circulating androgens and indexes of cardioautonomic function.
Study context
- Population
- Patients with T1D, consecutively recruited
- Participants
- 322 patients
- Exposure
- Women vs men with T1D, by age and menopausal status
- Outcome
- Prevalence of seemingly asymptomatic cardioautonomic neuropathy (Ewing's score and power spectral heart rate data)
Methodological detailsconsecutively recruited
- Consecutively recruited
Main finding
As reported in the abstract
Women >50 years vs young women
45.8% (32.6; 59.7) vs. 20.4% (13.7; 29.2)
OR of cardioautonomic neuropathy, women >50 years vs younger women
3.3
Observational data: associations, not effects.
Further findings
| Outcome | Peri- and menopausal women | Reproductive-aged women | OR (CI) | |
|---|---|---|---|---|
| Cardioautonomic neuropathy by menopausal status in women | 51% (CI 37–65) | 23% (CI 16–32) | 3.5 (1.7–7.2) | |
| 0.10.31310Odds ratio (log scale) |
Binary logistic regression for cardioautonomic neuropathy
- Model R2
- 0.161; P = 0.001
- Age >50 years a significant determinant only in women
Sex steroids and cardioautonomic function
- Androgens positively associated with heart rate variability in men, negatively in women
- Cardioautonomic neuropathy associated with increased testosterone/estradiol ratio in women and decreased testosterone in men
Original publication
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