Diabetes UK 2021 | Liver, pancreatic fats could underlie ‘disproportionately raised’ CV danger in ladies with diabetes


medwireNews: Women naturally have less liver and pancreatic fat than men, but type 2 diabetes eliminates this benefit and leads to a relatively greater increase in cardiovascular risk (CV). More data from DiRECT.

“Weight loss and remission of diabetes are therefore of particular importance for the cardiovascular health of women,” said moderator Ahmad Al-Mrabeh (Newcastle University, UK) to the participants of the virtual conference for Diabetes UK 2021.

He reported that liver and pancreatic fat levels were significantly lower in 12 women without diabetes than in 13 men. And while very low density lipoprotein (VLDL) triglyceride production was similar in both sexes, women had significantly lower fasting plasma levels than men.

The moderator said this is likely because women store VLDL triglyceride in their subcutaneous adipose tissue more effectively than men, which minimizes the amount that gets into the liver and pancreas.

He found that men are more prone to type 2 diabetes than women, but among those affected, women are at higher risk for CV than men.

The gender differences in liver and pancreatic fat were lost in 30 women and 34 men with type 2 diabetes from DiRECT’s Tyneside cohort; Both values ​​were significantly higher than in control women, while the liver fat values ​​were only increased in men. This happened even though women had significantly lower fasting plasma VLDL triglyceride levels than men.

Al-Mrabeh suggested this could be because women with type 2 diabetes have reached “maximum storage capacity” for triglyceride-rich lipids in their fat, or because they have “dysfunction in adipose tissue biology”.

When these women and men with diabetes lost weight over the course of DiRECT, they showed similar reductions in liver and pancreatic fat and VLDL triglyceride production. However, only men had significant reductions in fasting plasma levels of VLDL triglyceride and significantly greater reductions in total triglycerides.

Women with diabetes had significantly higher levels of unesterified fatty acids than men, and only women showed reductions consistent with dietary weight loss.

Still, both women and men benefited from weight loss by reducing their 10-year CV risk (based on the QRISK score), with the greatest benefit being seen in those whose diabetes was in remission and not relapsing.

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Diabetes UK Professional Conference 2021; April 19-30