性别相关的 2 型糖尿病老年患者初级保健中心血管危险因素控制差异：一项队列研究。

Gender-Related Differences in the Control of Cardiovascular Risk Factors in Primary Care for Elderly Patients With Type 2 Diabetes: A Cohort Study.

机构信息

Centre de recherche en Epidémiologie et Santé des Populations (CESP), Paris-Sud Faculty of Medicine, Paris-Sud University, INSERM, Université Paris-Saclay, Villejuif, France.

Centre de recherche en Epidémiologie et Santé des Populations (CESP), Paris-Sud Faculty of Medicine, Paris-Sud University, INSERM, Université Paris-Saclay, Villejuif, France; General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France.

出版信息

Can J Diabetes. 2018 Aug;42(4):365-371.e2. doi: 10.1016/j.jcjd.2017.08.248. Epub 2017 Oct 13.

DOI:10.1016/j.jcjd.2017.08.248

PMID:29037572

Abstract

OBJECTIVE

The aim of this study was to estimate the association between gender and control of diabetes and other cardiovascular risk factors in elderly patients with type 2 diabetes mellitus.

METHODS

The sujets âgés cohort is an observational study whose main objective was to describe the real-life management of elderly patients with type 2 diabetes mellitus in France. Nine hundred eighty-three patients with diabetes (517 men and 466 women) were recruited by 213 general practitioners and were followed up prospectively every 6 months for 3 years. Diabetes, hypertension and dyslipidemia were considered controlled if the glycated hemoglobin (A1C) was ≤7%, blood pressure was <140/90 mm Hg and low-density lipoprotein (LDL) cholesterol was ≤100 mg/dL. A1C levels and blood pressure measurements were recorded every 6 months for all patients. LDL cholesterol levels were optionally sampled every year.

RESULTS

Women were older than men (77.3±5.72 vs. 76.1±6.01 years), more likely to be alone, less likely to be smokers/ex-smokers and less likely to have cardiovascular disease at baseline. Mean A1C levels of female patients (6.98%±1.03%) did not differ from those of male patients (6.91%±0.96%). Mean blood pressure measurements during follow up were not different between male and female patients. In contrast, female patients had significantly higher LDL cholesterol levels than male counterparts (105.2±32.6 vs. 94.9±29.1 mg/dL), regardless of statin therapy.

CONCLUSION

Our results suggest no difference in the management of cardiovascular risk factors between elderly female patients with type 2 diabetes mellitus and their male counterparts, except for LDL cholesterol, which is significantly higher in women.

摘要

目的

本研究旨在评估性别与老年 2 型糖尿病患者糖尿病和其他心血管危险因素控制之间的关系。

方法

sujets âgés 队列是一项观察性研究，其主要目的是描述法国老年 2 型糖尿病患者的实际管理情况。983 名糖尿病患者（517 名男性和 466 名女性）由 213 名全科医生招募，并前瞻性随访 3 年，每 6 个月一次。如果糖化血红蛋白（A1C）≤7%、血压<140/90mmHg 和低密度脂蛋白（LDL）胆固醇≤100mg/dL，则认为糖尿病、高血压和血脂异常得到控制。所有患者每 6 个月记录一次 A1C 水平和血压测量值。LDL 胆固醇水平可选每年采样一次。

结果

女性患者比男性患者年龄更大（77.3±5.72 岁 vs. 76.1±6.01 岁），更有可能独居，更不可能吸烟/戒烟，且基线时更不可能患有心血管疾病。女性患者的平均 A1C 水平（6.98%±1.03%）与男性患者（6.91%±0.96%）无差异。随访期间，男性和女性患者的平均血压测量值无差异。相比之下，女性患者的 LDL 胆固醇水平明显高于男性患者（105.2±32.6 vs. 94.9±29.1mg/dL），无论是否接受他汀类药物治疗。