Sex Differences in Diabetes and Risk of Incident Coronary Artery Disease in Healthy Young and Middle-Aged Adults
Sex Differences in Diabetes and Risk of Incident Coronary Artery Disease in Healthy Young and Middle-Aged Adults
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DOI：
10.2337/dc13-1755
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发表时间：
2014-03-01
期刊：
影响因子：
16.2
通讯作者：
Vaidya, Dhananjay
中科院分区：
文献类型：
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作者：
Kalyani, Rita Rastogi;Lazo, Mariana;Vaidya, Dhananjay
糖尿病对中青年女性冠心病（CAD）的危险性存在争议。我们调查了不同潜在心脏病风险的健康个体中糖尿病状态在CAD中的性别差异。调整人口统计学，糖尿病与每个队列中女性的CAD率显著高出4 - 5倍相关，男性无差异。在三个队列的荟萃分析中，另外校正了BMI、吸烟、高血压、HDL和非HDL胆固醇、降压和降胆固醇药物的使用，男性与非糖尿病女性的CAD风险比为2.43（1.76-3.35），糖尿病为0.89（0.43-1.83）; P = 0.013糖尿病状态的相互作用。结论：虽然年轻和中年妇女在没有糖尿病的情况下不太可能发展为CAD，男女患糖尿病的风险相等。我们的研究结果支持积极的CAD预防策略，女性糖尿病患者和男性患者的水平相似。
OBJECTIVEControversy exists about the coronary artery disease (CAD) risk conveyed by diabetes in young and middle-aged women. We investigated sex differences in CAD by diabetes status among healthy individuals with different underlying risks of heart disease.RESEARCH DESIGN AND METHODSWe examined subjects aged 0.05. Adjusting for demographics, diabetes was associated with a significant four- to fivefold higher CAD rate among women in each cohort, without differences in men. In meta-analyses of three cohorts, additionally adjusted for BMI, smoking, hypertension, HDL, and non-HDL cholesterol, antihypertensive and cholesterol-lowering medication use, the hazard ratio of CAD in men versus women among nondiabetes was 2.43 (1.76-3.35) and diabetes was 0.89 (0.43-1.83); P = 0.013 interaction by diabetes status.CONCLUSIONSThough young and middle-aged women are less likely to develop CAD in the absence of diabetes, the presence of diabetes equalizes the risk by sex. Our findings support aggressive CAD prevention strategies in women with diabetes and at similar levels to those that exist in men.