Association of Kidney Function With 10-Year Risk of Atherosclerotic Cardiovascular Disease , Cardiovascular Disease and Its Risk Factors Among Women With Type 2 Diabetes Mellitus

Purpose: Women are at increased risk of developing kidney disease and cardiovascular disease (CVD) in their middle and older ages due to the impact of aging and hormonal variation associated with menopause transition. Women with diabetes are at greater risk of reduced kidney function. Reduced or even mildly reduced kidney function enhances the risk of developing atherosclerotic cardiovascular disease (ASCVD) among women with type 2 diabetes (T2D). Thus, the objective of this study is to determine the association of reduced or mildly reduced kidney function with an estimated 10-year risk of ASCVD, CVD, and cardiovascular risk factors among T2D women. Patients and Methods: This cross-sectional study is conducted among 393 T2D women, aged between 40-70 years, subdivided into three groups according to the level of estimated glomerular filtration rate (eGFR) (eGFR >= 90 mL/min/1.73m2(normal), eGFR 60-89 mL/min/1.73m2 (mildly reduced) and eGFR <60 mL/min/1.73m2 (reduced)). Association of kidney function with an estimated 10-year risk of ASCVD as well as cardiovascular disease was determined. Results: Based on the current study findings, the presence of cardiovascular disease was found to be associated with mildly reduced (p=0.014) and reduced eGFR (p=0.004) among T2D participants with previous CVD. No association was found between mildly reduced or reduced eGFR with an estimated 10-year intermediate/high risk for ASCVD among T2D women without CVD. Even though the level of eGFR was significantly varied between pre and post-menopause T2D women, no association of kidney function with estimated 10-year ASCVD risk was observed. Among cardiovascular risk factors, the presence of hypertension was associated with mildly reduced/reduced eGFR among T2D women. Conclusion: This study's findings highlight the graded, independent association of kidney function with cardiovascular disease among middle-aged and elderly T2D women with previous CVD, while no association with estimated 10-year risk for ASCVD among women without CVD.