Ballotari Paola, Venturelli Francesco, Greci Marina, Giorgi Rossi Paolo, Manicardi Valeria
Interinstitutional Epidemiology Unit, Local Health Authority of Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy; Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Viale Umberto I 50, 42123 Reggio Emilia, Italy.
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41126 Modena, Italy.
Int J Endocrinol. 2017;2017:6039356. doi: 10.1155/2017/6039356. Epub 2017 Feb 20.
The aim of the study is to assess sex difference in association between type 2 diabetes and incidence of major cardiovascular events, that is, myocardial infarction, stroke, and heart failure, using information retrieved by diabetes register. The inhabitants of Reggio Emilia (Italy) aged 30-84 were followed during 2012-2014. Incidence rate ratios and 95% confidence intervals were calculated using multivariate Poisson model. The age- and sex-specific event rates were graphed. Subjects with type 2 diabetes had an excess risk compared to their counterparts without diabetes for all the three major cardiovascular events. The excess risk is similar in women and men for stroke (1.8 times) and heart failure (2.7 times), while for myocardial infarction, the excess risk in women is greater than the one observed in men (IRR 2.58, 95% CI 2.22-3.00 and IRR 1.78, 95% CI 1.60-2.00, resp.; of interaction < ). Women had always a lesser risk than men, but in case of myocardial infarction, the women with type 2 diabetes lost part of advantage gained by women free of diabetes (IRR 0.61, 95% CI 0.53-0.72 and IRR 0.36, 95% CI 0.33-0.39, resp.). In women with type 2 diabetes, the risk of major cardiovascular events is anticipated by 20-30 years, while in men it is by 15-20.
本研究的目的是利用糖尿病登记处获取的信息，评估2型糖尿病与主要心血管事件（即心肌梗死、中风和心力衰竭）发生率之间的性别差异。对2012年至2014年期间意大利雷焦艾米利亚年龄在30 - 84岁的居民进行了随访。使用多变量泊松模型计算发病率比和95%置信区间。绘制了按年龄和性别划分的事件发生率图表。与无糖尿病的对应人群相比，2型糖尿病患者发生所有这三种主要心血管事件的风险更高。中风（1.8倍）和心力衰竭（2.7倍）的额外风险在女性和男性中相似，而对于心肌梗死，女性的额外风险大于男性（发病率比分别为2.58，95%置信区间为2.22 - 3.00和1.78，95%置信区间为1.60 - 2.00；交互作用< ）。女性的风险始终低于男性，但在心肌梗死方面，2型糖尿病女性失去了非糖尿病女性所具有的部分优势（发病率比分别为0.61，95%置信区间为0.53 - 0.72和0.36，95%置信区间为0.33 - 0.39）。在2型糖尿病女性中，主要心血管事件的风险提前20 - 30年出现，而在男性中则提前15 - 20年。
