Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo.
Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo.
Eur J Endocrinol. 2019 Apr;180(4):243-255. doi: 10.1530/EJE-18-0792.
Previous studies have shown sex-specific differences in all-cause and CHD mortality in type 2 diabetes. We performed a systematic review and meta-analysis to provide a global picture of the estimated influence of type 2 diabetes on the risk of all-cause and CHD mortality in women vs men.
We systematically searched PubMed, EMBASE and Web of Science for studies published from their starting dates to Aug 7, 2018. The sex-specific hazard ratios (HRs) and their pooled ratio (women vs men) of all-cause and CHD mortality associated with type 2 diabetes were obtained through an inverse variance-weighted random-effects meta-analysis. Subgroup analyses were used to explore the potential sources of heterogeneity.
The 35 analyzed prospective cohort studies included 2 314 292 individuals, among whom 254 038 all-cause deaths occurred. The pooled women vs men ratio of the HRs for all-cause and CHD mortality were 1.17 (95% CI: 1.12-1.23, I2 = 81.6%) and 1.97 (95% CI: 1.49-2.61, I2 = 86.4%), respectively. The pooled estimate of the HR for all-cause mortality was approximately 1.30 in articles in which the duration of follow-up was longer than 10 years and 1.10 in articles in which the duration of follow-up was less than 10 years. The pooled HRs for all-cause mortality in patients with type 2 diabetes was 2.33 (95% CI: 2.02-2.69) in women and 1.91 (95% CI: 1.72-2.12) in men, compared with their healthy counterparts.
The effect of diabetes on all-cause and CHD mortality is approximately 17 and 97% greater, respectively, for women than for men.
先前的研究表明，2 型糖尿病患者的全因死亡率和冠心病死亡率存在性别特异性差异。我们进行了系统评价和荟萃分析，以提供全球范围内 2 型糖尿病对女性和男性全因死亡率和冠心病死亡率风险影响的估计。
我们系统地检索了 PubMed、EMBASE 和 Web of Science 从其开始日期到 2018 年 8 月 7 日发表的研究。通过逆方差加权随机效应荟萃分析获得与 2 型糖尿病相关的全因死亡率和冠心病死亡率的性别特异性危险比（HR）及其合并比值（女性与男性）。亚组分析用于探讨潜在的异质性来源。
35 项分析性前瞻性队列研究纳入了 2314292 名个体，其中 254038 人发生了全因死亡。全因死亡率和冠心病死亡率的合并女性与男性 HR 比值分别为 1.17（95%CI：1.12-1.23，I2=81.6%）和 1.97（95%CI：1.49-2.61，I2=86.4%）。随访时间超过 10 年的文章中，全因死亡率的合并估计值约为 1.30，随访时间小于 10 年的文章中，合并估计值为 1.10。与健康对照组相比，2 型糖尿病女性患者的全因死亡率 HR 为 2.33（95%CI：2.02-2.69），男性患者的 HR 为 1.91（95%CI：1.72-2.12）。
与男性相比，女性糖尿病患者的全因死亡率和冠心病死亡率的影响分别高出约 17%和 97%。
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