Broni Eric K, Ndumele Chiadi E, Echouffo-Tcheugui Justin B, Kalyani Rita R, Bennett Wendy L, Michos Erin D
Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Curr Diab Rep. 2022 Jan;22(1):11-25. doi: 10.1007/s11892-021-01444-x. Epub 2022 Feb 14.
Cardiovascular disease (CVD) complications constitute about 50-70% of mortality in people with diabetes. However, there remains a persistently greater relative increase in CVD morbidity and mortality in women with diabetes than in their male counterparts. This review presents recent evidence for the risks, outcomes, and management implications for women with diabetes.
Compared to men, women have higher BMI and more adverse cardiovascular risk profile at time of diabetes diagnosis with greater risk for coronary heart disease, stroke, vascular dementia, and heart failure. Pregnancy-specific risk factors of gestational diabetes and pre-eclampsia are associated with future type 2 diabetes (T2D) and CVD. Women with T2D may experience greater benefits than men from GLP-1 receptor agonists. Women with diabetes are at greater relative risk for CVD complications than men, with poorer outcomes, superimposed on preexisting gender disparities in social determinants of health, lower likelihood of being offered cardioprotective interventions, and enrollment in trials. Further research and the utilization of SGLT-2 inhibitors, GLP-1 receptor agonists, and other CVD prevention strategies will help reduce morbidity and mortality.
心血管疾病（CVD）并发症约占糖尿病患者死亡率的50%-70%。然而，糖尿病女性的心血管疾病发病率和死亡率的相对增幅持续高于男性。本综述介绍了有关糖尿病女性风险、结局及管理意义的最新证据。
与男性相比，女性在糖尿病诊断时BMI更高，心血管风险状况更差，患冠心病、中风、血管性痴呆和心力衰竭的风险更高。妊娠期糖尿病和子痫前期等特定于妊娠的风险因素与未来2型糖尿病（T2D）和心血管疾病相关。T2D女性使用胰高血糖素样肽-1（GLP-1）受体激动剂可能比男性获益更大。糖尿病女性发生CVD并发症的相对风险高于男性，结局更差，同时还存在健康社会决定因素方面原有的性别差异、接受心脏保护干预的可能性较低以及参与试验的比例较低等问题。进一步的研究以及使用钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂、GLP-1受体激动剂和其他心血管疾病预防策略将有助于降低发病率和死亡率。
