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J Hypertens:糖尿病对女性的危害更大

2017-09-17 聚焦高血压编辑部 聚焦高血压

既往有研究证明,男性更容易患糖尿病,但糖尿病对女性的危害更大。糖尿病与性别之间确实存在交互作用吗?来自法国、比利时、瑞典、智利等国的研究者,收集了7个随机对照试验的数据,共计3万多例患者个体的数据,通过分析多个心血管终点事件,试图回答上述问题。


既往有研究证明,男性更容易患糖尿病,但糖尿病对女性的危害更大。糖尿病与性别之间确实存在交互作用吗?来自法国、比利时、瑞典、智利等国的研究者,收集了7个随机对照试验的数据,共计3万多例患者个体的数据,通过分析多个心血管终点事件,试图回答上述问题。

该研究通过30560例患者个体的心血管结局数据,旨在分析性别和2型糖尿病的交互作用。初步结果在ESH2017年的会议上公布。

该研究采用比例风险回归Cox模型,通过单变量和多变量分析分别检验这种交互作用,以及其他重要的危险因素。研究数据来自7个随机对照试验,包Coope、EWPHE、MRFIT、SHEP、STOP、SYSTEUR(INDANA数据库)和DIABHYCAR。

研究纳入的患者年龄在35~98岁之间,有高血压、伴或不伴2型糖尿病,有心血管病史。最长随访期为11.87年,中位随访期为4.97年。研究中的心血管结局包括猝死,全因死亡,心血管死亡,致死性心肌梗死卒中和冠心病。

主要结果

不管是单变量分析还是多变量分析,男性和糖尿病患者发生猝死、所有死亡、心血管死亡、致死性心肌梗死、卒中和冠心病的风险均更高,除了多变量分析中男性与卒中发生风险之外。这种交互作用,除了在单变量分析中的冠心病和多变量分析中的心血管死亡、卒中和冠心病外,均有显著性。

患有糖尿病的女性发生猝死、总体死亡和致命性心肌梗死的风险分别比患有糖尿病的男性平均高85%、23%和24%,差异均有显著统计学意义。在心血管死亡、卒中和冠心病中也观察到了同样的趋势,但这些结果没有显著统计学意义。

主要结论

在该研究的数据库中,校正治疗、试验、年龄、吸烟、收缩压、总胆固醇和心肌梗死病史之后,性别和2型糖尿病在猝死、总体死亡和致命性心肌梗死方面存在显著的交互作用。

该研究结果与既往发表的文献结果一致,对于非糖尿病个体而言,男性的风险通常比女性更高;但是,对于糖尿病个体,女性的心血管预后更差。


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    2018-05-02 feather89
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    2017-09-18 flysky120

    糖尿病应该更早发现.控制.

    0

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    2017-09-17 130****4638

    学习了谢谢分享

    0

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    2017-09-17 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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    2017-09-17 changjiu

    学习了.谢谢

    0

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