Gender Disparities in Lipid Goal Attainment among Type 2 Diabetes Outpatients with Coronary Heart Disease: Results from the CCMR-3B Study

Abstract

Our study was aimed to investigate the gender disparities in lipid goal attainment among type 2 diabetes outpatients with concomitant coronary heart disease (CHD) and explore potential risk factors. We performed the present analysis using data from a nationally representative epidemiologic study. The therapeutic goal was defined as achieving a low-density lipoprotein cholesterol (LDL-C) <1.8 mmol/L. A total of 1721 male and 2072 female type 2 diabetes outpatients with established CHD were identified. Compared with men, women had higher levels of total cholesterol (4.98 vs. 4.46 mmol/L; p < 0.001), LDL-C (2.82 vs. 2.54 mmol/L; p < 0.001), and triglycerides (2.02 vs. 1.79 mmol/L; p < 0.001), but not hemoglobin A1c (7.47% vs. 7.50%; p = 0.597). The proportion of women received lipid-lowering therapy was lower (38.1% vs. 48.2%; p < 0.001). The percentages of patients who achieved the LDL-C goal were higher among men. Multivariable regression analysis indicated that the odds ratio for lipid goal attainment due to the gender difference was 0.61 after adjusting confounders. The inability to achieve LDL-C goals in women with type 2 diabetes and CHD is apparently greater than that in men. This finding underscores the importance of initiatives to establish a more aggressive lipid management strategy for women to overcome gender imbalances.

Figure 1

Relative differences in LDL-C goal attainment.