Sex difference in development of diabetes and cardiovascular disease on the way from obesity and metabolic syndrome -: Prospective study of a cohort with normal glucose metabolism
Sex difference in development of diabetes and cardiovascular disease on the way from obesity and metabolic syndrome -: Prospective study of a cohort with normal glucose metabolism
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DOI：
10.1016/j.metabol.2005.01.025
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发表时间：
2005-06-01
影响因子：
9.8
通讯作者：
Sansoy, V
中科院分区：
文献类型：
--
作者：
Onat, A;Hergenç, G;Sansoy, V
目的：本研究的目的是调查存在的性别特异性差异的方式（腹部）肥胖和代谢综合征（MS）的2型糖尿病（DM）和心血管疾病（CVD），方法：人口样本1974名男性和女性，土耳其成年人（平均年龄49岁）的代表，与正常的葡萄糖代谢（GM）和免费的CVD在基线。在平均4.1年的随访中进行了前瞻性评价。术语异常GM指定DM和空腹血糖受损（IFG）。根据国家胆固醇教育计划指南的标准，代谢综合征在29%的男性和40%的女性中被确定，致命和非致命性心血管疾病，通过临床发现和静息心电图的明尼苏达编码诊断，在121名受试者中发展。该队列根据是否存在MS和肥胖（定义为体重指数30 kg/m2或更高）进行二分，与没有肥胖或MS的主要女性组相比，MS女性，无论是否存在肥胖，都高度显著地预测了异常GM的发展，相对风险超过2，而在男性MS患者中没有发现独立的显著相关性。类似的性别差异与糖尿病的预测有关。当年龄、吸烟状况、体力活动等级、IFG、DM以及肥胖和MS的4组通过logistic回归分析来预测CVD时，MS男性无论是否存在肥胖，都高度显著地预测CVD（相对风险范围为2至4），但DM和IFG均无独立贡献。相反，在女性中，GM异常预测CVD独立于年龄，吸烟状态和体力活动等级，但肥胖和MS组未能独立做出显著贡献。在MS流行的人群中，GM正常的女性在MS背景下易于发生DM，并且主要通过DM暴露于CVD风险，而男性易于发生内脏肥胖，对DM不敏感，并且主要通过MS的中介来运行CVD风险，在很大程度上独立于DM组件。(c)2005年爱思唯尔公司All rights reserved.
Aim: The objective of this study was to investigate sex-specific differences existing on the way from (abdominal) obesity and metabolic syndrome (MS) to type 2 diabetes mellitus (DM) and cardiovascular disease (CVD),Methods: A population sample of 1974 men and women, representative of Turkish adults (mean age, 49 years), with normal glucose metabolism (GM) and free of CVD at baseline. was prospectively evaluated at a mean 4.1 years of follow-up. The term abnormal GM designated both DM and impaired fasting glucose (IFG). Metabolic syndrome was identified in 29% of men and 40% of women by the criteria of the National Cholesterol Education Program guidelines, Fatal and nonfatal CVD, diagnosed by clinical findings and Minnesota coding of resting electrocardiograms, developed in 121 subjects.Results: The cohort was dichotomized by the presence or absence of MS and of obesity defined by a body mass index of 30 kg/m(2) or greater, Compared with the major female group with no obesity or MS, women with MS, regardless of the presence of obesity, predicted highly significantly the development of abnormal GM with relative risks exceeding 2, whereas no independent significant association was noted in men with MS. Similar divergence of sexes pertained to the prediction of diabetes. When age, smoking status, grade of physical activity, IFG, DM, and the 4 groups with obesity and MS were analyzed for the prediction of CVD by logistic regression, men with MS. regardless of the presence of obesity, predicted highly significantly CVD (with relative risks ranging from 2 to 4), but neither DM nor IFG contributed independently. Conversely, in women, abnormal GM predicted CVD independent of age, smoking Status, and grade of physical activity, but the groups with obesity and MS failed to significantly contribute independently.Conclusions: In populations with prevalent MS, whereas women with normal GM are prone to DM within the context of MS and are exposed to CVD risk primarily by way of DM, men are prone to visceral adiposity, less susceptible to DM, and run CVD risk primarily by the intermediary of MS, largely independent of the DM component. (c) 2005 Elsevier Inc. All rights reserved.