Primary Health Care Center Raval, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Catala de la Salut, Avenida Drassanes 17-21, 08001 Barcelona, Spain ; Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari de Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Avenida Gran Via de les Corts Catalanes, 587 Àtic, 08007 Barcelona, Spain.
Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari de Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Avenida Gran Via de les Corts Catalanes, 587 Àtic, 08007 Barcelona, Spain ; Primary Health Care Center La Mina, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Catala de la Salut, C/Mar s/n, Sant Adrià de Besòs, 08930 Barcelona, Spain.
Int J Endocrinol. 2014;2014:131709. doi: 10.1155/2014/131709. Epub 2014 Sep 21.
The objective of this cross-sectional study was to assess differences in the control and treatment of modifiable cardiovascular risk factors (CVRF: HbA1c, blood pressure [BP], LDL-cholesterol, body mass index, and smoking habit) according to gender and the presence of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. The study included available data from electronic medical records for a total of 286,791 patients. After controlling for sex, age, diabetes duration, and treatment received, both men and women with prior CVD had worse cardiometabolic control than patients without previous CVD; women with prior CVD had worse overall control of CVRFs than men except for smoking; and women without prior CVD were only better than men at controlling smoking and BP, with no significant differences in glycemic control. Finally, although the proportion of women treated with lipid-lowering medications was similar to (with prior CVD) or even higher (without CVD) than men, LDL-cholesterol levels were remarkably uncontrolled in both women with and women without CVD. The results stress the need to implement measures to better prevent and treat CVRF in the subgroup of diabetic women, specifically with more intensive statin treatment in those with CVD.
本横断面研究旨在评估 2 型糖尿病（T2DM）患者中，根据性别和心血管疾病（CVD）的存在，在可改变的心血管风险因素（CVRF：糖化血红蛋白、血压[BP]、低密度脂蛋白胆固醇、体重指数和吸烟习惯）的控制和治疗方面存在的差异。该研究纳入了西班牙加泰罗尼亚地区电子病历中的可用数据，共涉及 286791 名患者。在控制了性别、年龄、糖尿病病程和接受的治疗后，与无既往 CVD 的患者相比，有既往 CVD 的男性和女性的代谢控制更差；有既往 CVD 的女性除吸烟外，整体 CVRF 控制情况均差于男性；而无既往 CVD 的女性仅在控制吸烟和 BP 方面优于男性，血糖控制则无显著差异。最后，尽管接受降脂药物治疗的女性比例与男性相似（有既往 CVD）或甚至更高（无 CVD），但无论是否有 CVD，女性的 LDL 胆固醇水平都显著失控。这些结果强调了需要采取措施，更好地预防和治疗糖尿病女性亚组的 CVRF，特别是对有 CVD 的患者进行更强化的他汀类药物治疗。
