Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis - PubMed (original) (raw)
Review
Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis
Alka M Kanaya et al. Arch Intern Med. 2002 Aug.
Abstract
Background: Most studies suggest that diabetes is a stronger coronary heart disease (CHD) risk factor for women than men, but few have adjusted their results for classic CHD risk factors: age, hypertension, total cholesterol level, and smoking.
Objective: To establish an accurate estimate of the odds ratio for fatal and nonfatal CHD due to diabetes in both men and women.
Methods: We compared the summary odds ratio for CHD mortality and the absolute rates of CHD mortality in men and women with diabetes. We searched the MEDLINE and Cochrane Collaboration databases and bibliographies of relevant articles and consulted experts. Studies that included a nondiabetic control group and provided sex-specific adjusted results for CHD mortality, nonfatal myocardial infarction, and cardiovascular or all-cause mortality were included. Of 4578 articles identified, 232 contained primary data, and 182 were excluded. Two reviewers recorded data on study characteristics, quality, and outcomes from 50 studies.
Results: Sixteen studies met all inclusion criteria. In unadjusted and age-adjusted analyses, odds of CHD death were higher in women than men with diabetes. From 8 prospective studies, the multivariate-adjusted summary odds ratio for CHD mortality due to diabetes was 2.3 (95% confidence interval, 1.9-2.8) for men and 2.9 (95% confidence interval, 2.2-3.8) for women. There were no significant sex differences in the adjusted risk associated with diabetes for CHD mortality, nonfatal myocardial infarction, and cardiovascular or all-cause mortality. Absolute CHD death rates were higher for diabetic men than women in every age strata except the very oldest.
Conclusions: The excess relative risk of CHD mortality in women vs men with diabetes was absent after adjusting for classic CHD risk factors, but men had more CHD deaths attributable to diabetes than women.
Similar articles
- The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women: 20 years of follow-up.
Hu FB, Stampfer MJ, Solomon CG, Liu S, Willett WC, Speizer FE, Nathan DM, Manson JE. Hu FB, et al. Arch Intern Med. 2001 Jul 23;161(14):1717-23. doi: 10.1001/archinte.161.14.1717. Arch Intern Med. 2001. PMID: 11485504 - Alcohol consumption and risk of coronary heart disease among men with type 2 diabetes mellitus.
Tanasescu M, Hu FB, Willett WC, Stampfer MJ, Rimm EB. Tanasescu M, et al. J Am Coll Cardiol. 2001 Dec;38(7):1836-42. doi: 10.1016/s0735-1097(01)01655-2. J Am Coll Cardiol. 2001. PMID: 11738282 - Type 2 diabetes as a "coronary heart disease equivalent": an 18-year prospective population-based study in Finnish subjects.
Juutilainen A, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Juutilainen A, et al. Diabetes Care. 2005 Dec;28(12):2901-7. doi: 10.2337/diacare.28.12.2901. Diabetes Care. 2005. PMID: 16306552 - Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies.
Huxley R, Barzi F, Woodward M. Huxley R, et al. BMJ. 2006 Jan 14;332(7533):73-8. doi: 10.1136/bmj.38678.389583.7C. Epub 2005 Dec 21. BMJ. 2006. PMID: 16371403 Free PMC article. Review. - Risk factors for coronary heart disease in women.
Hennekens CH. Hennekens CH. Cardiol Clin. 1998 Feb;16(1):1-8. doi: 10.1016/s0733-8651(05)70378-7. Cardiol Clin. 1998. PMID: 9507775 Review.
Cited by
- General and gender characteristics of type 2 diabetes mellitus among the younger and older age groups.
Al-Mukhtar SB, Fadhil NN, Hanna BE. Al-Mukhtar SB, et al. Oman Med J. 2012 Sep;27(5):375-82. doi: 10.5001/omj.2012.94. Oman Med J. 2012. PMID: 23074547 Free PMC article. - Assessment of coronary heart diseases in diabetics in al-Madinah al-Munawarah.
Al-Nozha O, Mojadadi M, Mosaad M, El-Bab MF. Al-Nozha O, et al. Int J Gen Med. 2012;5:143-9. doi: 10.2147/IJGM.S27373. Epub 2012 Feb 22. Int J Gen Med. 2012. PMID: 22393300 Free PMC article. Retracted. - Cardiometabolic Risk Factors and Incident Cardiovascular Disease Events in Women vs Men With Type 1 Diabetes.
Braffett BH, Bebu I, El Ghormli L, Cowie CC, Sivitz WI, Pop-Busui R, Larkin ME, Gubitosi-Klug RA, Nathan DM, Lachin JM, Dagogo-Jack S; DCCT/EDIC Research Group. Braffett BH, et al. JAMA Netw Open. 2022 Sep 1;5(9):e2230710. doi: 10.1001/jamanetworkopen.2022.30710. JAMA Netw Open. 2022. PMID: 36074461 Free PMC article. Clinical Trial. - Lipid abnormalities in the metabolic syndrome.
Brinton EA. Brinton EA. Curr Diab Rep. 2003 Feb;3(1):65-72. doi: 10.1007/s11892-003-0056-3. Curr Diab Rep. 2003. PMID: 12643148 Review. - Gender-Related Factors in Medication Adherence for Metabolic and Cardiovascular Health.
Venditti V, Bleve E, Morano S, Filardi T. Venditti V, et al. Metabolites. 2023 Oct 17;13(10):1087. doi: 10.3390/metabo13101087. Metabolites. 2023. PMID: 37887412 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous