Earlier Development of Diabetic Neuropathy in Men Than in Women With Type 2 Diabetes Mellitus
Earlier Development of Diabetic Neuropathy in Men Than in Women With Type 2 Diabetes Mellitus
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DOI：
10.1016/j.genm.2010.11.001
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发表时间：
2010-12-01
期刊：
影响因子：
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通讯作者：
Georgieva, Rumyana Taneva
中科院分区：
文献类型：
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作者：
Kamenov, Zdravko Asenov;Parapunova, Rumyana Atanasova;Georgieva, Rumyana Taneva
背景：关于糖尿病神经病变（DN）患病率的数据差异很大，这取决于人群和诊断方法。性别特异性差异在DN很少discussed.Objectives：本研究的目的是评估的患病率，并分析性别差异，DN在医院人口与2型糖尿病（T2 DM）超过18 years.Methods：在这项回顾性研究中进行的大学医院内分泌诊所在索菲亚，从1990年至2007年的患者的临床记录进行了检查。结果：分析了1705例T2 DM患者的数据（961例女性，744例男性;平均[SD]年龄，60.0 [11.9]岁;糖尿病病程，9.9 [8.4]年;糖化血红蛋白，9.0% [2.2%];体重指数，29.4 [6.0] kg/m2）。肥胖（46.3%vs32.0%，P < 0.001）、高血压（86.7%vs77.8%，P < 0.001）和血脂异常（61.2%vs55.0%，P < 0.05）在女性中分别显著高于男性。DN患病率为78.8%，性别差异无统计学意义。然而，患病率随时间而不同，对应于电生理（肌电图）或半定量仪器诊断方法的应用频率。在男性中，诊断T2 DM和诊断DN之间的中位（第25 - 75位）间隔为6（1-12）年;在女性中，间隔为8（4-13）年（P < 0.01）。在这些患者中观察到DN的高患病率。男性从T2 DM诊断到DN的时间比女性短，这需要对男性DN进行早期筛查和治疗干预。这种性别差异的原因可能包括生活方式的差异和男性糖尿病患者常见的睾酮缺乏，导致神经类固醇更明显的缺乏。(Gend 2010;7：600-615）（C）2010 Elsevier HS Journals，Inc.
Background: Data about the prevalence of diabetic neuropathy (DN) differ substantially, depending on the population and diagnostic methods. Sex-specific differences in DN are rarely discussed.Objectives: The aims of the present study were to assess the prevalence of, and analyze sex differences in, DN in a hospital population with type 2 diabetes mellitus (T2DM) over a period of 18 years.Methods: In this retrospective study performed at a university hospital endocrinology clinic in Sofia, patient clinical records from 1990-2007 were examined. Patients were included in the database only at their first admission.Results: Data from 1705 patients with T2DM were analyzed (961 women, 744 men; mean [SD] age, 60.0 [11.9] years; diabetes duration, 9.9 [8.4] years; glycosylated hemoglobin, 9.0% [2.2%]; and body mass index, 29.4 [6.0] kg/m(2)). Obesity (46.3% vs 32.0%; P < 0.001), hypertension (86.7% vs 77.8%; P < 0.001), and dyslipidemia (61.2% vs 55.0%; P < 0.05) were significantly more common in women than in men, respectively. The prevalence of DN was 78.8%, with no significant sex differences. However, prevalence differed with time, corresponding to the frequency of application of electrophysiologic (electromyograms) or semiquantitative instrumental diagnostic methods. In men, the median (25th-75th percentiles) interval between diagnosis of T2DM and diagnosis of DN was 6 (1-12) years; in women, the interval was 8 (4-13) years (P < 0.01).Conclusions: In this study of Bulgarian patients with T2DM, women were at higher macrovascular risk than were men. A high prevalence of DN was observed among these patients. The period from the diagnosis of T2DM to DN was shorter in men than in women this necessitates earlier screening and therapeutic intervention for DN in men. Reasons for this sex difference may include differences in lifestyle and the testosterone deficiency that is common in men with diabetes, leading to a more pronounced deficit of neurosteroids. (Gend Med. 2010;7:600-615) (C) 2010 Elsevier HS Journals, Inc.