Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Department of Endocrinology, Peking University People's Hospital, Beijing, China.
Diabetes Res Clin Pract. 2018 Mar;137:119-127. doi: 10.1016/j.diabres.2017.10.025. Epub 2017 Oct 29.
To investigate the risk of Chinese females versus males for non-fatal coronary heart disease (CHD) due to long exposure to type 2 diabetes mellitus (T2DM).
223,612 Chinese patients with T2DM were recruited from China in 2012. Binary logistic regression analysis was performed to obtain odds ratios (OR) of females versus males for non-fatal CHD. Additive interaction was used to test whether female gender and long exposure to T2DM (≥15 years) had a synergistic effect for non-fatal CHD. Significant relative excess risk due to interaction (RERI > 0), attributable proportion due to interaction (AP > 0) or synergy index (SI > 1) suggest a significant additive interaction.
More females than males with T2DM had non-fatal CHD (11.3% versus 10.6%, P < .0001). Females had slightly higher risk of non-fatal CHD since 5-10 years of diabetic duration and the effect size became larger since 15 years and onwards. Overall effect of females versus males for non-fatal CHD was 1.04 (95% CI: 1.01-1.08) among patients with <15 years of duration while the effect size increased to 1.17 (95% CI: 1.07-1.28) among patients with ≥15 years of duration. Using males with <15 years of duration as the reference, females with ≥15 years of duration were at 1.82-fold (95% CI: 1.70-1.95) non-fatal CHD risk while males with ≥15 years of duration were only at 1.56 (95% CI: 1.45-1.68) fold non-fatal CHD risk, with significant additive interaction (all three measures < 0.05).
Long exposure to T2DM imparted a larger risk of non-fatal CHD to Chinese females than to Chinese males.
研究中国女性与男性相比，因长期暴露于 2 型糖尿病（T2DM）而患非致死性冠心病（CHD）的风险。
2012 年，在中国招募了 223612 名患有 T2DM 的中国患者。采用二项逻辑回归分析女性与男性相比非致死性 CHD 的比值比（OR）。相加交互作用用于检验女性性别和 T2DM 长暴露（≥15 年）对非致死性 CHD 是否具有协同作用。显著的交互作用归因超额危险度（RERI>0）、交互作用归因比例（AP>0）或协同指数（SI>1）提示存在显著的相加交互作用。
患有 T2DM 的女性患者发生非致死性 CHD 的比例高于男性患者（11.3%比 10.6%，P<0.0001）。女性患者在糖尿病病程 5-10 年时发生非致死性 CHD 的风险略高，且自 15 年及以上时，这种影响逐渐增大。在病程<15 年的患者中，女性与男性相比非致死性 CHD 的总体效应为 1.04（95%可信区间：1.01-1.08），而在病程≥15 年的患者中，这一效应值增大至 1.17（95%可信区间：1.07-1.28）。以病程<15 年的男性为参照，病程≥15 年的女性发生非致死性 CHD 的风险为 1.82 倍（95%可信区间：1.70-1.95），而病程≥15 年的男性发生非致死性 CHD 的风险仅为 1.56 倍（95%可信区间：1.45-1.68），存在显著的相加交互作用（所有三个指标均<0.05）。
T2DM 长期暴露使中国女性发生非致死性 CHD 的风险大于中国男性。
