Sex differences in cardiovascular and total mortality among diabetic and non-diabetic individuals with or without history of myocardial infarction
Sex differences in cardiovascular and total mortality among diabetic and non-diabetic individuals with or without history of myocardial infarction
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DOI：
10.1007/s00125-005-1730-6
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发表时间：
2005-05-01
期刊：
影响因子：
8.2
通讯作者：
Tuomilehto, J
中科院分区：
文献类型：
--
作者：
Hu, G;Jousilahti, P;Tuomilehto, J
目的/假设：我们调查了2型糖尿病和心肌梗死（MI）病史与冠心病、中风、心血管疾病和总死亡率的关系，以及这些影响在男性和女性中是否不同。方法：研究队列包括51，735名年龄在25-74岁之间的芬兰男性和女性。记录吸烟情况、MI和2型糖尿病病史，并测量基线时身高、体重、血压和血清胆固醇水平。基线调查前糖尿病和MI发生率的其他数据通过计算机化登记链接从国家医院出院和药物登记处获得。死亡率数据来自国家死亡率登记册。结果：在平均17.2年的随访期间，记录了9，201例死亡。与既无糖尿病也无心肌梗死史的男性相比，单纯糖尿病男性、单纯心肌梗死男性、糖尿病合并心肌梗死男性的冠状动脉死亡风险比（HR）分别为2.1、4.0和6.4。女性的相应HR分别为4.9、2.5和9.4。男性心血管和总死亡率的等效HR分别为2.2、3.3和6.0，1.8、2.3和3.7，女性分别为4.4、2.4和6.5，3.2、1.7和4.4。糖尿病男性和女性的总死亡率相似，而其他三种糖尿病-MI类别的男性总死亡率明显较高。结论/解释：糖尿病和MI显著增加心血管和全因死亡率。在女性中，糖尿病与死亡率之间的关联强于MI与死亡率之间的关联，而在男性中则匡威。
Aims/hypothesis: We investigated the associations of type 2 diabetes and a history of myocardial infarction (MI) with coronary heart disease, stroke, cardiovascular and total mortality, and whether these effects are different in men and women. Methods: Study cohorts included 51,735 Finnish men and women aged 25-74 years. Smoking status and the history of MI and type 2 diabetes were recorded, and height, weight, blood pressure and serum cholesterol levels were measured at baseline. Additional data on the occurrence of diabetes and MI prior to baseline survey were obtained from national hospital discharge and drug registers through computerised register linkage. Mortality data were obtained from the national mortality register. Results: During a mean follow-up period of 17.2 years, 9,201 deaths were recorded. Hazard ratios (HRs) for coronary mortality were 2.1, 4.0 and 6.4 among men with diabetes alone, men with MI alone, and men with diabetes and MI, respectively, compared with men with neither diabetes nor a history of MI. The corresponding HRs among women were 4.9, 2.5 and 9.4, respectively. The equivalent HRs for cardiovascular and total mortality were 2.2, 3.3 and 6.0, and 1.8, 2.3 and 3.7 in men, and 4.4, 2.4 and 6.5, and 3.2, 1.7 and 4.4 in women, respectively. Diabetic men and women had similar total mortality rates, whereas total mortality rates were markedly higher among men in the other three diabetes-MI categories. Conclusions/interpretation: Diabetes and MI markedly increase cardiovascular and all-cause mortality. In women, the association between diabetes and mortality was stronger than that between MI and mortality, whereas the converse was true among men.