Song Do Kyeong, Sung Yeon-Ah, Hong Young Sun, Kim Min-Ho, Lee Hyejin
Department of Internal Medicine, Ewha Womans University School of Medicine, 25 Magokdong-ro 2-gil, Gangseo-gu, Seoul, 07804, Korea.
Ewha Womans University Seoul Hospital, Ewha Medical Data Organization, Seoul, Korea.
Sci Rep. 2025 Jul 15;15(1):25450. doi: 10.1038/s41598-025-01768-8.
People with diabetes or prediabetes face a higher risk of cardiovascular events. However, the impact of sex and menopausal hormone therapy on cardiovascular disease (CVD) in these individuals remains unclear. We examined cardiovascular event risk and the association between menopausal hormone therapy and CVD risk in female Koreans with diabetes or prediabetes. We utilized the National Health Insurance Service database from 2009 to 2019. People undergoing hemodialysis or with an eGFR < 15 mL/min/1.73 m were excluded. We analyzed 1,313,591 people with prediabetes and 890,184 people with diabetes without a history of heart failure. Additionally, we examined 1,180,576 people with prediabetes and 673,688 people with diabetes without a history of acute myocardial infarction or stroke. Hazard ratios (HRs) for CVD risk were calculated using Cox proportional hazards models. Women with diabetes had a higher risk of heart failure compared to men with diabetes (HR: 1.095, 95% CI 1.068 to 1.123), a pattern also seen in people with prediabetes (HR: 1.150, 95% CI 1.118 to 1.183). Conversely, women with diabetes had a lower risk of acute myocardial infarction (HR: 0.507, 95% CI 0.486 to 0.528) and stroke (HR: 0.787, 95% CI 0.771 to 0.804) compared to men with diabetes, which was similarly observed in people with prediabetes. Hormone therapy was linked to a reduced risk of ischemic stroke in postmenopausal women with diabetes (HR: 0.761, 95% CI 0.589 to 0.983) and prediabetes (HR: 0.659, 95% CI 0.488 to 0.889). Women with diabetes or prediabetes have a higher risk of heart failure than men. More intensive screening and management of heart failure are needed, especially for these women. Conversely, women with diabetes or prediabetes have a lower risk of acute myocardial infarction and stroke compared to men. Menopausal hormone therapy may help prevent ischemic stroke in postmenopausal women with diabetes or prediabetes.
患有糖尿病或糖尿病前期的人面临更高的心血管事件风险。然而，性别和绝经激素治疗对这些个体心血管疾病（CVD）的影响仍不明确。我们研究了患有糖尿病或糖尿病前期的韩国女性的心血管事件风险以及绝经激素治疗与CVD风险之间的关联。我们利用了2009年至2019年的国民健康保险服务数据库。接受血液透析或估算肾小球滤过率（eGFR）<15 mL/（min·1.73 m²）的人被排除在外。我们分析了1313591例糖尿病前期患者和890184例无心力衰竭病史的糖尿病患者。此外，我们还研究了1180576例糖尿病前期患者和673688例无急性心肌梗死或中风病史的糖尿病患者。使用Cox比例风险模型计算CVD风险的风险比（HRs）。与患有糖尿病的男性相比，患有糖尿病的女性发生心力衰竭的风险更高（HR：1.095，95%CI为1.068至1.123），这种模式在糖尿病前期患者中也可见（HR：1.
