Sex Differences in Conventional Coagulation and Platelet Parameters Among Adults with Type 2 Diabetes: A Cross-Sectional Study in Mongolia

Background: Sex-related differences in hemostasis may contribute to variation in cardiovascular risk among individuals with type 2 diabetes mellitus (T2DM); however, evidence regarding conventional coagulation and platelet parameters in this population remains limited. This study investigated sex differences in coagulation and platelet parameters among adults with T2DM in Mongolia. Methods: This cross-sectional study included 250 adults with T2DM. Conventional coagulation parameters, including activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), and fibrinogen, as well as platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), were evaluated. Between-sex differences were assessed using appropriate parametric or nonparametric tests. Sequential linear regression models were used to examine associations with sex, with progressive adjustment for age, body mass index, current smoking, alcohol use, HbA1c, diabetes duration, and chronic diabetic complication status. Results: Of 250 participants, 117 were men and 133 were women. Women had shorter PT (10.20 [9.90–10.53] vs. 10.70 [10.28–11.10] s; p < 0.001), lower INR (0.96 [0.92–0.98] vs. 1.00 [0.96–1.04]; p < 0.001), and shorter aPTT (25.90 [24.80–27.30] vs. 26.70 [25.18–27.90] s; p = 0.045), while platelet count (281 [238.5–329] vs. 243 [205–278] ×109/L; p < 0.001) and PCT (0.271 [0.234–0.320] vs. 0.236 [0.201–0.283]%; p < 0.001) were higher in women. In the fully adjusted model, female sex remained associated with shorter PT (B = −0.499 s, 95% CI −0.747 to −0.250; p < 0.001) and lower INR (B = −0.051, 95% CI −0.072 to −0.029; p < 0.001), as well as higher platelet count (B = 37.838 × 109/L, 95% CI 19.012–56.663; p < 0.001) and PCT (B = 0.034%, 95% CI 0.005–0.063; p = 0.024). aPTT was not independently associated with sex after adjustment (B = −0.551 s, 95% CI −1.333 to 0.231; p = 0.166). Conclusions: Among Mongolian adults with T2DM, women had shorter PT and INR and higher platelet count and PCT than men after multivariable adjustment. Although aPTT differed between sexes in the unadjusted comparison, the association was not significant in regression analysis. These findings demonstrate sex-related variation in routinely measured hemostatic parameters in T2DM and support consideration of biological sex when interpreting these laboratory measures.