Department of Meridian & Acupoint, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
BMJ Open. 2024 May 23;14(5):e081789. doi: 10.1136/bmjopen-2023-081789.
Previous studies on the differences in the mechanism and complications of diabetes between men and women have indicated potential sex differences in cardiovascular health, which affect health-related quality of life (HRQoL).
A cross-sectional cohort study.
To determine how sex differences can be noticed, acknowledged and applied in clinical practice, we aimed to determine the cardiovascular (CV) health status of men and women with diabetes and its effects on HRQoL.
In total, 2829 individuals with diabetes (1518 men and 1311 women) aged ≥40 years who participated in the Korean National Health and Nutrition Examination Survey from 2013 to 2018 were enrolled.
Individuals with diabetes were categorised into poor, intermediate and ideal groups based on CV health indicators recommended by the American Heart Association. We used EQ-5D-3L to compare HRQoL scores between the sexes. Multivariable ordinal logistic regression and analysis of covariance were used to analyse the outcome variables.
In the poor CV health score group, female sex was associated with mobility problems (OR 1.93, 95% CI 1.46 to 2.54), problems with usual activities (OR1.71, 95% CI 1.24 to 2.35), pain/discomfort (OR 1.69, 95% CI 1.32 to 2.16) and anxiety/depression (OR 1.66 95% CI 1.16 to 2.38). In the intermediate and ideal CV health score groups, female sex was associated with pain/discomfort (OR 1.57, 95% CI 1.15 to 2.15). Men had higher EQ-5D index scores in the poor and intermediate CV health score groups than did women.
Although women tended to have high health-related CV health scores, HRQoL was lower in women than in men, especially in the poor CV health score group and in the pain/discomfort domain.
之前关于男性和女性糖尿病发病机制和并发症差异的研究表明，心血管健康方面存在潜在的性别差异，这会影响健康相关生活质量（HRQoL）。
一项横断面队列研究。
为了确定如何注意到、认识到并将性别差异应用于临床实践中，我们旨在确定患有糖尿病的男性和女性的心血管（CV）健康状况及其对 HRQoL 的影响。
共有 2829 名年龄≥40 岁的糖尿病患者（男性 1518 名，女性 1311 名）参加了 2013 年至 2018 年期间的韩国国家健康和营养检查调查，被纳入本研究。
根据美国心脏协会推荐的 CV 健康指标，将糖尿病患者分为 CV 健康状况差、中等和理想三组。我们使用 EQ-5D-3L 比较了性别之间的 HRQoL 评分。使用多变量有序逻辑回归和协方差分析来分析结果变量。
在 CV 健康评分较差的组中，女性与行动问题（OR 1.93，95%CI 1.46 至 2.54）、日常活动问题（OR 1.71，95%CI 1.24 至 2.35）、疼痛/不适（OR 1.69，95%CI 1.32 至 2.16）和焦虑/抑郁（OR 1.66，95%CI 1.16 至 2.38）有关。在中等和理想的 CV 健康评分组中，女性与疼痛/不适（OR 1.57，95%CI 1.15 至 2.15）有关。在 CV 健康评分较差和中等的组中，男性的 EQ-5D 指数评分均高于女性。
尽管女性的心血管健康相关评分往往较高，但女性的 HRQoL 低于男性，尤其是在 CV 健康评分较差的组和疼痛/不适领域。
