Diabetes and prediabetes are known risk factors for heart disease, one of the top leading causes of death in America and around the world. A systematic review and meta-analysis found an even greater association between diabetes and heart disease risk in women than men. With 10.5% of the U.S. population diagnosed with diabetes and 34.5% of U.S. adults with prediabetes, many public health campaigns incorporate tips regarding screening, preventing, and managing diabetes to also reduce the risk of associated conditions such as heart disease.

Doctors and other health-care professionals use many screening tools, such as bloodwork for HbA1c and lipid profiles, and the risk of modifiable lifestyle factors, such as smoking and lack of exercise, to discern an individual’s risk factors for developing diabetes and/or heart disease. A recent study found one such marker that may provide key information for the link between the risk of both diabetes and heart disease in women called the lipoprotein insulin resistance score; this is a novel composite of metabolomic biomarkers shown to have a high correlation with diabetes, even among those who have an otherwise optimal clinical profile.

In a prospective cohort study using data from 28,024 female participants of the Women’s Health Study, researchers reviewed 50 known clinical and biomarker risk factors associated with coronary heart disease. From these factors, the highest associated relative risks were lipoprotein insulin resistance and diabetes, especially for early onset of heart disease, demonstrating an important potential connection between impaired glucose metabolism and the development of cardiovascular disease. 

In the participants who were younger than age 55 when first diagnosed with heart disease, the adjusted hazard ratio for diabetes was 10.71, which reduced with age to become 3.47 in those 75 years and older. Metabolic syndrome, which also involves blood sugar dysregulation, was also highly associated with heart disease before age 55, as was hypertension and smoking. Among the biomarkers, lipoprotein insulin resistance, which had an adjusted 6.4 hazard ratio for women younger than age 55 and attenuating with advancing age, had the strongest correlation with heart disease risk. For comparison, hazard ratios of common heart disease biomarkers included 1.38 for low-density lipoprotein cholesterol levels, 1.89 for apolipoprotein B, and 2.15 for triglycerides. Another study found that fasting blood glucose and HbA1c may also demonstrate the severity of cardiovascular disease, at least in prediabetic patients.

Maintaining normal blood sugar levels achieves much more than just the reduction of risk of developing diabetes, as it also supports heart health, especially for women. Healthy lifestyle factors, such as consuming a healthy diet, maintaining physical activity, and obtaining restful sleep may also support healthy glucose metabolism, in addition to certain nutritional supplements, such as magnesium, chromium, probiotics, zinc, and berberine. 

By Kendra Whitmore, MS, CNS