Department of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Internal Medicine, Maxima Medical Center, Eindhoven, The Netherlands.
Acta Diabetol. 2020 Jun;57(6):725-732. doi: 10.1007/s00592-020-01489-6. Epub 2020 Feb 5.
Type 2 diabetes mellitus is a major cause of death and disability due to its long-term macro- and microvascular diseases. Although women with type 2 diabetes have more macrovascular diseases, it is unclear whether there are sex differences in the occurrence of microvascular disease. The aim of our study was to investigate sex differences in the incidence of microvascular complications in type 2 diabetes.
Analyses were performed in the DiaGene study, a prospective cohort study for complications of type 2 diabetes, collected in the city of Eindhoven, the Netherlands (n = 1886, mean follow-up time = 6.93 years). Cox proportional hazard models adjusted for risk factors for complications (age, smoking, hypertension, dyslipidemia, HbA1c and duration of type 2 diabetes) were used to analyze the incidence of microvascular complications in men and women.
The incidence of microalbuminuria was significantly higher in men (HR microalbuminuria 1.64 [CI 1.21-2.24], p = 0.002). Additionally, men are more likely to develop two or three microvascular complications compared to women (OR 2.42 [CI 1.69-3.45], p < 0.001).
This study shows that men with type 2 diabetes are more likely to develop microvascular complications, especially microalbuminuria. Furthermore, men seem to have a higher chance of developing multiple microvascular complications. Our results highlight that men and women may not benefit to a similar extent from current treatment approaches to prevent diabetes-related microvascular diseases.
2 型糖尿病是导致死亡和残疾的主要原因,因为它会导致长期的大血管和微血管疾病。尽管患有 2 型糖尿病的女性有更多的大血管疾病,但在微血管疾病的发生方面是否存在性别差异尚不清楚。我们的研究目的是调查 2 型糖尿病患者微血管并发症发生的性别差异。
在 DiaGene 研究中进行了分析,这是一项针对 2 型糖尿病并发症的前瞻性队列研究,在荷兰埃因霍温市收集(n=1886,平均随访时间=6.93 年)。使用 Cox 比例风险模型调整并发症的危险因素(年龄、吸烟、高血压、血脂异常、HbA1c 和 2 型糖尿病病程)来分析男性和女性微血管并发症的发生率。
男性微量白蛋白尿的发生率明显更高(HR 微量白蛋白尿 1.64 [CI 1.21-2.24],p=0.002)。此外,与女性相比,男性更有可能发展为两种或三种微血管并发症(OR 2.42 [CI 1.69-3.45],p<0.001)。
这项研究表明,2 型糖尿病男性更易发生微血管并发症,尤其是微量白蛋白尿。此外,男性似乎更有可能发生多种微血管并发症。我们的研究结果表明,男性和女性可能不会从当前预防糖尿病相关微血管疾病的治疗方法中获得同等程度的获益。