Division of Nephrology, University of Washington, Seattle, WA 98108, USA.
Am J Nephrol. 2012;36(3):245-51. doi: 10.1159/000342210. Epub 2012 Sep 4.
BACKGROUND/AIMS: Women with diabetes experience a disproportionately greater burden of diabetic kidney disease (DKD) risk factors compared to men; however, sex-specific differences in DKD are not well defined. The effect of age on sex differences in DKD is unknown.
We performed a cross-sectional analysis of the prevalence of DKD (eGFR <60 ml/min/1.73 m(2) or microalbuminuria), advanced DKD (eGFR <30 ml/min/1.73 m(2)), and common DKD risk factors in the Pathways Study (n = 4,839), a prospective cohort study of diabetic patients from a managed care setting. Subjects were stratified by age <60 and ≥60 years to examine for differences by age. Logistic regression models examined the association between sex and prevalence of DKD and risk factors.
Women of all ages had 28% decreased odds of DKD (OR 0.72, 95% CI 0.62-0.83); however, they had a greater prevalence of advanced DKD (OR 1.67, 95% CI 1.05-2.64), dyslipidemia (OR 1.42, 95% CI 1.16-1.74), and obesity (OR 1.87, 95% CI 1.60-2.20) compared to men. Women had similar odds of hypertension and poor glycemic control as men. Women ≥60 years had increased odds of advanced DKD, hypertension, dyslipidemia, and obesity compared to similarly aged men. Women <60 years had increased odds of obesity compared to their male counterparts.
Women with diabetes had an increased prevalence of advanced DKD and common DKD risk factors compared to men and these disparities were most prominent amongst the elderly.
背景/目的：与男性相比，患有糖尿病的女性经历的糖尿病肾病（DKD）风险因素负担不成比例地更大；然而，DKD 的性别差异尚不清楚。年龄对 DKD 性别差异的影响尚不清楚。
我们对来自管理式医疗环境的糖尿病患者前瞻性队列研究 Pathways 研究（n=4839）中 DKD（eGFR<60 ml/min/1.73 m2 或微量白蛋白尿）、晚期 DKD（eGFR<30 ml/min/1.73 m2）和常见 DKD 风险因素的患病率进行了横断面分析。根据年龄<60 岁和≥60 岁对受试者进行分层，以检查年龄差异。Logistic 回归模型检查了性别与 DKD 和风险因素患病率之间的关联。
所有年龄段的女性 DKD 的可能性降低 28%（OR 0.72，95%CI 0.62-0.83）；然而，与男性相比，她们患有晚期 DKD（OR 1.67，95%CI 1.05-2.64）、血脂异常（OR 1.42，95%CI 1.16-1.74）和肥胖（OR 1.87，95%CI 1.60-2.20）的患病率更高。女性患高血压和血糖控制不佳的可能性与男性相似。≥60 岁的女性与同龄男性相比，患有晚期 DKD、高血压、血脂异常和肥胖的可能性增加。<60 岁的女性与男性相比，肥胖的可能性增加。
与男性相比，患有糖尿病的女性患有晚期 DKD 和常见 DKD 风险因素的患病率增加，这些差异在老年人中最为明显。
