sex Hormones May Explain Disparities in Heart Disease Risk for People With Diabetes
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A new study suggests that fluctuations in sex hormones – testosterone adn estradiol – could be key to understanding why individuals with type 2 diabetes experience varying levels of heart disease risk, with potential implications for more personalized prevention strategies.
People living with type 2 diabetes face a considerably elevated risk of heart attacks, strokes, and other cardiovascular conditions.However, research indicates this risk isn’t uniform. A team at Johns Hopkins Medicine has begun to unravel teh biological factors contributing to these differences between men and women.
“we are very interested in understanding why women who have diabetes don’t always experience the same level of cardiovascular protection as men,” explains study lead author, dr. Nityasree Srialluri, a cardiologist and assistant professor of medicine at the Johns hopkins University School of Medicine. “We hypothesized that sex hormones could play a role.”
The study, published in Diabetes Care, involved over 400 participants with type 2 diabetes. Researchers leveraged the study’s extended follow-up period, allowing them to analyze blood samples collected both at the study’s outset and one year later, tracking changes in sex hormone levels.
Hormonal Patterns Differ Between Men and Women
The analysis revealed distinct patterns in men and women. Among male participants,higher testosterone levels at the start of the study correlated with a lower risk of heart disease. Conversely,increases in estradiol levels over the one-year period were associated with a heightened risk.
However, researchers did not find the same clear correlations among female participants. This suggests that hormones may exert different influences on heart disease risk depending on sex, or that other biological and clinical factors might potentially be more dominant in women with diabetes.
toward Personalized Heart disease Prevention
These results underscore the potential value of incorporating sex hormone tracking into routine care for individuals with diabetes. “Results from this study contribute to our understanding of how tracking sex hormones in people with diabetes could complement what we already know about traditional heart disease risk factors [like smoking and cholesterol levels],” the researcher notes. “The results could help clinicians personalize heart disease prevention strategies in the future.”
Looking ahead, the research team plans to investigate the interplay between hormones, diabetes, and other health outcomes, including bone health and fracture risk. They are also preparing new studies focused on hormonal changes during menopause – also known as perimenopause – and their impact on cardiovascular risk, especially in individuals with chronic conditions like diabetes.
The study’s coauthors include Teresa Gisinger, M.D., Ph.D., Jiahuan Helen He, M.H.S., Chigolum Oyeka, MBBS, M.P.H., Jianqiao Ma, ScM, Nityasree Srialluri, M.D., M.S., M.H.S., Mark Woodward, Ph.D., Erin D. Michos,M.D., M.H.S., Rita R. Kalyani, M.D., M.H.S., Jeanne M. Clark,M.D., M.P.H., Alexandra Kautzky-Willer, M.D., and Dhananjay Vaidya, MBBS, Ph.D., M.P.H.
Jeanne M. Clark, M.D., M.P.H., reports serving as a scientific advisor to Boehringer Ingelheim and receiving writng support from Novo Nordisk in the last three years. Erin D. Michos, M.D., M.H.S., has served as a consultant for numerous pharmaceutical companies, including Amgen, AstraZeneca, and Novartis.
This research was supported by grants R01DK127222 and U01DK57149 from the National Institute of Health’s Diabetes and Digestive and Kidney Diseases.
