Sex-specific-differences in cardiometabolic risk in type 1 diabetes: a cross-sectional study
Sex-specific-differences in cardiometabolic risk in type 1 diabetes: a cross-sectional study
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DOI：
10.1186/1475-2840-12-78
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发表时间：
2013-05-24
影响因子：
9.3
通讯作者：
Lemmens-Gruber, Rosa
中科院分区：
文献类型：
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作者：
Kautzky-Willer, Alexandra;Stich, Kathrin;Lemmens-Gruber, Rosa
背景资料：性别差异对1型糖尿病（T1DM）治疗的影响知之甚少。因此，我们评估了性别对T1DM患者的危险因素、并发症、临床护理和依从性的影响。方法：在一项横断面研究中，性别在血糖控制、心血管危险因素、糖尿病并发症、在225名连续患者中评价了伴随药物的使用和对治疗建议的依从性（45.3%的女性）在年龄、糖尿病病程和体重指数方面具有可比性。尽管T1DM女性患者的总胆固醇高于男性，但肥胖男性和HbA1c>7%的男性患者的甘油三酯高于女性患者。在贫血控制和微血管或大血管并发症中未观察到性别差异。然而，亚组分析显示，肾病在肥胖男性、糖尿病女性和所有高血压患者中更常见，而周围神经病变在糖尿病女性中更常见。视网膜病变更常见于HbA1c> 7%的女性、肥胖男性和糖尿病病程较长的男性。多变量分析显示，男性和女性的微血管并发症与病程和BMI相关，而男性与糖尿病相关。根据指导方针，男性对干预措施的总体坚持率高于女性。这种坚持特别关注的是与合并用药的患者诊断为高血压，阿司匹林处方的老年患者和实现目标血脂水平的处方statins.Conclusions：我们的数据显示，血脂和超重的T1DM患者的性别差异。尽管两种性别之间的血糖控制和糖尿病并发症的发生率相当，但女性对指南的总体依从性，特别是关于他汀类药物和阿司匹林处方的依从性，低于男性。
Background: Little is known about the impact of sex-specific differences in the management of type 1 diabetes (T1DM).Thus, we evaluated the influence of gender on risk factors, complications, clinical care and adherence in patients with T1DM.Methods: In a cross-sectional study, sex-specific disparities in glycaemic control, cardiovascular risk factors, diabetic complications, concomitant medication use and adherence to treatment recommendations were evaluated in 225 consecutive patients (45.3% women) who were comparable with respect to age, diabetes duration, and body mass index.Results: Although women with T1DM had a higher total cholesterol than men, triglycerides were higher in obese men and males with HbA1c>7% than in their female counterparts. No sex differences were observed in glycaemic control and in micro-or macrovascular complications. However, the subgroup analysis showed that nephropathy was more common in obese men, hyperlipidaemic women and all hypertensive patients, whereas peripheral neuropathy was more common in hyperlipidaemic women. Retinopathy was found more frequently in women with HbA1c>7%, obese men and in both sexes with a long duration of diabetes. The multivariate analysis revealed that microvascular complications were associated with the duration of disease and BMI in both sexes and with hyperlipidaemia in males. The overall adherence to interventions according to the guidelines was higher in men than in women. This adherence was concerned particularly with co-medication in patients diagnosed with hypertension, aspirin prescription in elderly patients and the achievement of target lipid levels following the prescription of statins.Conclusions: Our data showed sex differences in lipids and overweight in patients with T1DM. Although glycaemic control and the frequency of diabetic complications were comparable between the sexes, the overall adherence to guidelines, particularly with respect to the prescription of statins and aspirin, was lower in women than in men.