Sex Disparity in Cardiovascular Mortality in Patient with EndStage Renal Disease and Type 2 Diabetes Mellitus

Abstract Aim: We hypothesized that sex differences relative to the pro-inflammatory and endothelial markers may exist and play a role in the higher CVD mortality of women with End-Stage Renal Disease and Type 2 Diabetes Mellitus. Methods: 15 subjects (average age of 54 ± 9 years, 8 females and 7 males) on Peritoneal Dialysis (PD) were enrolled. Evaluation of Endothelial Function (EF) was done by Reactive Hyperemia Index (RHI). Serum levels of EF biomarkers: Endo Thelin (ET) 1, Plasminogen Activator Inhibitor 1 (PAI-1), soluble Vascular Adhesion Molecule 1 (sVCAM) and soluble Inter Cellular Adhesion Molecule 1 (sICAM); and inflammatory markers: Inter Leukin 6 (IL-6), IL-1β, Tumor Necrosis Factor alpha (TNF-α) and C- Reactive Protein (CRP) were measured. A non-parametric Wilcoxon test was performed for all the study parameters. Conclusion: The combined increase of IL-1β and ET1 found in the females of this study population reflects significant sex difference in the expression of these inflammatory markers that may actually be responsible for the increase in CVD mortality among diabetic females with ESRD on PD. Larger scale studies are warranted to confirm this conclusion that may guide future studies to control CVD mortality