Gender Differences in Cardiometabolic Risk Factors and Indicators of Aortic Stiffness in Individuals with Prediabetes

Objective: Cardiometabolic risk factors and biomarkers reflecting various pathophysiological pathways differ between men and women. In this study, gender differences were analyzed in some cardiometabolic risk indices and evaluated the indicators of arterial stiffness (AS) in men compared to women with prediabetes (preD) without cardiovascular disease. Methods: Data from 581 individuals (189 with normal plasma glucose and 392 with preD, aged 18-86 years) were analyzed cross-sectionally. The relationship between gender and different biomarkers was evaluated. Aortic stiffness index (ASI) was used to represent AS and was calculated as follows: ln [systolic blood pressure (SBP)/ diastolic blood pressure]/ [(ascending aorta systolic diameter − ascending aorta diastolic diameter (ADS)]/ADS. Multivariable linear regression was used to explore indicators of ASI. Results: Women with preD were older than men. The frequencies of comorbidities were significantly higher in preD men. Epicardial adipose tissue (EAT) (4.27 Å} 1.87 vs. 3.77 Å} 1.94), ASI (15.78 Å} 11.34 vs. 12.22 Å} 13.04), and lipid accumulation product index (LAPI) [59.98 (51.68) vs. 54.36 (57.04)] were significantly higher in preD men than in preD women. There was a significant correlation between ASI and age, body mass index (BMI), metabolic syndrome, waist circumference (WC), EAT, LAPI, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), insulin, creatinine, glomerular filtration rate (GFR), and SBP. In men, ASI was significantly correlated with age, MetS, BMI, WC, EAT, FPG, HOMA-IR, HbA1c, GFR, red blood cell distribution width, and SBP. Conclusion: These findings highlight that the development of AS in preD may be due to common and sex-specific risk factors.