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HDL gender gap temporarily disappears under acute stress in diabetic patients
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In patients with diabetes, the gender gap that is usually observed in HDL cholesterol is not in evidence upon hospital admission for metabolic decompensation but returns when acute stress has resolved, according to recent findings.
In the study, researchers evaluated 179 patients (88 women) with diabetes and metabolic decompensation to determine if the gender gap of HDL is maintained during acute stress. The researchers collected information on the duration of diabetes in these patients, treatments, chronic comorbidity history and acute morbidities involved in hospital admission.
Upon resolution of the acute metabolic decompensation, the researchers measured height, weight and BMI of the patients. They also measured HbA1c, fasting plasma glucose, total cholesterol, HDL and LDL and triglycerides within 24 hours of hospitalization and later at outpatient follow-up examinations.
The researchers found that at admission, there were no significant differences in fasting lipid concentrations, with comparable levels of serum total cholesterol, triglycerides, LDL and HDL. Additionally, measures of glucose control including HbA1c and serum glucose were comparable between the genders at admission.
A subset analysis compared pre-admission HDL and HDL at hospital presentation data (35 women; 24 men) revealed a decrease in HDL, with a more pronounced decrease in women (P=.005).
At outpatient follow-up, which occurred approximately 4 months after admission, the changes in triglycerides, LDL and total cholesterol from baseline did not differ between the genders. Conversely, while both groups demonstrated increases in HDL at follow-up, there was a significantly greater increase in women (P=.003). This increase had been temporarily nullified during metabolic decompensation (P=.0016).
According to researchers, these findings suggest that repeat episodes of acute stress may have the overall effect of eliminating the HDL gender gap in women.
“Loss of HDL-[cholesterol] gender gap during acute stress raises the question whether recurrent episodes may lead to cumulative loss of the HDL advantage in females,” the researchers wrote. “Recovery from acute stress may serve as a spontaneous experimental model to study the generation of HDL-[cholesterol] gender gap. A better understanding of mechanisms involved may provide insights into new pathways for therapeutic action to enhance HDL function.”
Disclosure: The researchers report no relevant financial disclosures.
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