Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
The George Institute for Global Health, School of Public Health, Imperial College London, London, UK; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Diabetes Res Clin Pract. 2022 Jun;188:109899. doi: 10.1016/j.diabres.2022.109899. Epub 2022 May 5.
Diabetes has been associated with a greater excess risk of cardiovascular disease (CVD) in women than men. We investigated whether there are also sex differences in the association of diabetes duration and the risk of CVD.
Data were used from 18,961 (40% women) individuals with type 2 diabetes, without a history of CVD, in the UK Biobank. Sex-specific incidence rates were calculated by diabetes duration. Cox proportional hazards analyses estimated multiple-adjusted sex-specific hazard ratios (HR) and women-to-men ratio of HRs (RHR).
Over a median follow-up of 11 years, 1,506 (29% women) CVD events were documented. Compared with men, women had lower multiple-adjusted incidence rates of CVD per 10,000 person-years for all categories of diabetes duration. Duration of diabetes was associated with an increased risk of CVD in both sexes. A 5-year increase in diabetes duration was associated with an approximately similar excess risk of about 20% for each of the three endpoints, in both sexes.
CONCLUSIONS/INTERPRETATION: The increased risk of CVD associated with longer duration of diabetes is similar in women and men, and thus cannot explain the higher excess risk from diabetes in women in this study population.
糖尿病与女性心血管疾病（CVD）的超额风险比男性更高。我们研究了糖尿病持续时间与 CVD 风险之间的关联是否存在性别差异。
本研究使用了英国生物库中 18961 名（40%为女性）无 CVD 病史的 2 型糖尿病患者的数据。按糖尿病持续时间计算了性别特异性发病率。Cox 比例风险分析估计了多重调整后的性别特异性危险比（HR）和女性与男性 HR 的比值（RHR）。
在中位随访 11 年期间，记录了 1506 例（29%为女性）CVD 事件。与男性相比，所有糖尿病持续时间类别的女性 CVD 发病率每 10000 人年都较低。糖尿病持续时间与 CVD 风险增加相关，无论性别如何。在两性中，糖尿病持续时间每增加 5 年，三个终点的超额风险大约相似，均增加约 20%。
结论/解释：糖尿病持续时间较长与 CVD 风险增加的相关性在女性和男性中相似，因此，在本研究人群中，不能用这一机制来解释女性糖尿病的超额风险更高。
