Abstract
OBJECTIVE: Sex differences in the association of HbA1c and cardiovascular disease (CVD) risk remain controversial. We examined CVD risk profile in both HbA1c-defined diabetic and nondiabetic men and women. METHODS: We conducted a cross-sectional analysis of 7139 Chinese adults using data from the China Health and Nutrition Survey 2009. RESULTS: HbA1c-defined nondiabetic men have a more favorable CVD risk profile than female counterparts. However, HbA1c-defined diabetic men have higher levels of triglyceride, low-density lipoprotein (LDL)-cholesterol, and triglyceride/high-density lipoprotein (HDL)-cholesterol and lower levels of HDL-cholesterol, be more visceral obese as indicated by visceral adiposity index (VAI) and lipid accumulation product (LAP), and more insulin resistant as assessed by the triglycerides and glucose index (TyG) than HbA1c-defined diabetic women. Furthermore, HbA1c-defined diabetic men showed greater relative differences in ferritin than diabetic women when compared with their nondiabetic counterparts. Statistically significant sex by HbA1c-defined diabetes status interactions were observed for triglyceride, LDL-cholesterol, HDL-cholesterol, triglyceride/HDL cholesterol, VAI, LAP, TyG, and ferritin (all ps < 0.05). Consideration of VAI or homeostasis model assessment of insulin resistance or both failed to eliminate the sex differences in the associations between diabetes and these CVD risk factors. CONCLUSIONS: Men who progressed from HbA1c-defined nondiabetes to HbA1c-defined diabetes have greater metabolic deteriorations and put on more visceral adiposity than women. Key messages HbA1c-defined nondiabetic men have a more favorable CVD risk profile than female counterparts. Men have to undergo a greater metabolic deterioration to develop HbA1c-defined diabetes than do women. Men have to put on more visceral adiposity to develop HbA1c-defined diabetes than do women.