Risk factor control and incident cardiovascular disease in patients with diabetes: Sex-specific relations

被引:2
作者
Wang, Xuan [1 ]
Ma, Hao [1 ]
Li, Xiang [1 ]
Liang, Zhaoxia [1 ,2 ]
Fonseca, Vivian [3 ,4 ]
Qi, Lu [1 ,5 ]
机构
[1] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, 1440 Canal St,Suite 1724, New Orleans, LA 70112 USA
[2] Zhejiang Univ, Sch Med, Womens Hosp, Obstetr Dept, Hangzhou, Peoples R China
[3] Tulane Univ, Sch Med, Sect Endocrinol & Metab, New Orleans, LA USA
[4] Southeast Louisiana Vet Hlth Care Syst, New Orleans, LA USA
[5] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA
关键词
cardiovascular disease; diabetes; risk factor control; CORONARY-HEART-DISEASE; MULTIFACTORIAL INTERVENTION; SCIENTIFIC STATEMENT; MORTALITY; MELLITUS; OUTCOMES; WOMEN; METAANALYSIS; MEN; ASSOCIATION;
D O I
10.1111/dom.15443
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
AimWomen with diabetes are at higher risk of cardiovascular diseases (CVD) than men with diabetes; however, the sex difference in the association between the degree of risk factor control and the risk of CVD in patients with diabetes is unclear.MethodsIn total, 17 260 participants diagnosed with diabetes from the UK Biobank were included and matched with 86 300 non-diabetes controls based on age, sex and assessment centre. The main exposure was the number of risk factors within the target range, including glycated haemoglobin level <53 mol/mol (7%), blood pressure <140/90 mm/Hg, low-density lipoprotein cholesterol <100 mg/dl, non-current smoking and absence of microalbuminuria.ResultsDuring a median follow-up of 13.3 years, a total of 3338 incident CVD cases, including 2807 ischaemic heart disease and 793 strokes, were documented. A more stringent control of risk factors was significantly associated with a lower risk of incident CVD, and such an association was significantly stronger in women than men. Compared with non-diabetes participants, the diabetes-related risk of CVD appeared to be eliminated if more than three risk factors were well controlled among women and men with diabetes. Moreover, clinical biomarkers (e.g. glycated haemoglobin and blood pressure) showed greater relative importance than other factors in women, whereas socio-economic and psychological factors (e.g. education and depression) exhibited similar relative importance to clinical biomarkers in men with diabetes.ConclusionOur findings highlighted the importance of raising awareness of sex differences in the management of CVD risk factors among patients with diabetes.
引用
收藏
页码:1421 / 1429
页数:9
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