Sex Hormones Linked to Heart Disease Risk in Type 2 Diabetes

A Johns Hopkins Medicine-led study has explored the role of sex hormones in the differing cardiovascular disease risks observed between men and women with type 2 diabetes. Individuals with type 2 diabetes face an increased risk of heart attacks, strokes, and other cardiovascular issues, with these risks exhibiting variations based on sex.

The research was published in Diabetes Care and received funding from the National Institutes of Health. It utilized data from the Look Ahead study, which investigated the impact of weight loss on heart health outcomes in people with type 2 diabetes. Researchers analyzed participants' blood samples to assess sex hormone levels at the start of the trial and after one year.

Among male participants, higher testosterone levels at the study's commencement were associated with a lower risk of heart disease.

Key Study Findings

• Among male participants, higher testosterone levels at the study's commencement were associated with a lower risk of heart disease.
• Increases in estradiol levels after one year were linked to a higher risk of heart disease in men.
• For women, no significant connections were identified between these specific hormone levels and cardiovascular outcomes.

Implications and Future Directions

Researchers indicated that these findings contribute to understanding how tracking sex hormones in people with diabetes could supplement knowledge of traditional heart disease risk factors. This information may help clinicians in developing personalized heart disease prevention strategies in the future.

Next steps for the research include examining how weight loss and hormones affect bone health in individuals with diabetes. Additionally, researchers plan to identify how hormone declines during perimenopause might influence cardiovascular risk, especially in people with chronic illnesses such as diabetes.

Disclosures

Several researchers involved in the study reported financial relationships. Dr. Clark reported serving as a scientific advisor to Boehringer Ingelheim and receiving writing support from Novo Nordisk. Dr. Michos reported serving as a consultant for multiple pharmaceutical and medical device companies, including Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, and Novo Nordisk, unrelated to this specific work.