Chadalavada Sucharitha, Reinikainen Jaakko, Andersson Jonas, Di Castelnuovo Augusto, Iacoviello Licia, Jousilahti Pekka, Kårhus Line Lund, Linneberg Allan, Söderberg Stefan, Tunstall-Pedoe Hugh, Lekadir Karim, Aung Nay, Jensen Magnus T, Kuulasmaa Kari, Niiranen Teemu J, Petersen Steffen E
William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom.
Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom.
Front Cardiovasc Med. 2023 Apr 25;10:1136764. doi: 10.3389/fcvm.2023.1136764. eCollection 2023.
Diabetes and its cardiovascular complications are a growing concern worldwide. Recently, some studies have demonstrated that relative risk of heart failure (HF) is higher in women with type 1 diabetes (T1DM) than in men. This study aims to validate these findings in cohorts representing five countries across Europe.
This study includes 88,559 (51.8% women) participants, 3,281 (46.3% women) of whom had diabetes at baseline. Survival analysis was performed with the outcomes of interest being death and HF with a follow-up time of 12 years. Sub-group analysis according to sex and type of diabetes was also performed for the HF outcome.
6,460 deaths were recorded, of which 567 were amongst those with diabetes. Additionally, HF was diagnosed in 2,772 individuals (446 with diabetes). A multivariable Cox proportional hazard analysis showed that there was an increased risk of death and HF (hazard ratio (HR) of 1.73 [1.58-1.89] and 2.12 [1.91-2.36], respectively) when comparing those with diabetes and those without. The HR for HF was 6.72 [2.75-16.41] for women with T1DM vs. 5.80 [2.72-12.37] for men with T1DM, but the interaction term for sex differences was insignificant ( for interaction 0.45). There was no significant difference in the relative risk of HF between men and women when both types of diabetes were combined (HR 2.22 [1.93-2.54] vs. 1.99 [1.67-2.38] respectively, for interaction 0.80).
Diabetes is associated with increased risks of death and heart failure, and there was no difference in relative risk according to sex.
糖尿病及其心血管并发症在全球范围内日益受到关注。最近，一些研究表明，1型糖尿病（T1DM）女性发生心力衰竭（HF）的相对风险高于男性。本研究旨在验证这些发现在代表欧洲五个国家的队列中的情况。
本研究纳入88559名参与者（51.8%为女性），其中3281名（46.3%为女性）在基线时患有糖尿病。进行生存分析，感兴趣的结局为死亡和HF，随访时间为12年。还对HF结局按性别和糖尿病类型进行了亚组分析。
记录到6460例死亡，其中567例发生在糖尿病患者中。此外，2772人被诊断为HF（446例患有糖尿病）。多变量Cox比例风险分析显示，与非糖尿病患者相比，糖尿病患者死亡和HF的风险增加（风险比（HR）分别为1.73[1.58 - 1.89]和2.12[1.91 - 2.36]）。T1DM女性的HF HR为6.72[2.75 - 16.41]，T1DM男性为5.80[2.72 - 12.37]，但性别差异的交互项不显著（交互作用P值为0.45）。两种糖尿病合并时，男性和女性HF的相对风险无显著差异（HR分别为2.22[1.93 - 2.54]和1.99[1.67 - 2.38]，交互作用P值为0.80）。
糖尿病与死亡和心力衰竭风险增加相关，且相对风险不存在性别差异。
