Sex differences in risk of incident microvascular and macrovascular complications: a population-based data-linkage study among 25 713 people with diabetes.

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Alice A Gibson, Emma Cox, Francisco J Schneuer, Jacob Humphries, Crystal My Lee, Joanne Gale, Steven Chadban, Mark Gillies, Clara K Chow, Stephen Colagiuri, Natasha Nassar
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Abstract

Background: The global prevalence of diabetes is similar in men and women; however, there is conflicting evidence regarding sex differences in diabetes-related complications. The aim of this study was to investigate sex differences in incident microvascular and macrovascular complications among adults with diabetes.

Methods: This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study sample included 25 713 individuals (57% men), aged ≥45 years, with diabetes at baseline. Incident cardiovascular disease (CVD), eye, lower limb, and kidney complications were determined using hospitalisation data and claims for medical services. Multivariable Cox proportional hazards models were used to assess the association between sex and incident complications.

Results: Age-adjusted incidence rates per 1000 person years for CVD, eye, lower limb, and kidney complications were 37, 52, 21, and 32, respectively. Men had a greater risk of CVD (adjusted hazard ratio (aHR) 1.51, 95% CI 1.43 to 1.59), lower limb (aHR 1.47, 95% CI 1.38 to 1.57), and kidney complications (aHR 1.55, 95% CI 1.47 to 1.64) than women, and a greater risk of diabetic retinopathy (aHR 1.14, 95% CI 1.03 to 1.26). Over 10 years, 44%, 57%, 25%, and 35% of men experienced a CVD, eye, lower limb, or kidney complication, respectively, compared with 31%, 61%, 18%, and 25% of women. Diabetes duration (<10 years vs ≥10 years) had no substantial effect on sex differences in complications.

Conclusions: Men with diabetes are at greater risk of complications, irrespective of diabetes duration. High rates of complications in both sexes highlight the importance of targeted complication screening and prevention strategies from diagnosis.

微血管和大血管并发症发病风险的性别差异:对 25 713 名糖尿病患者进行的基于人群的数据链接研究。
背景:在全球范围内,男性和女性的糖尿病发病率相似;然而,关于糖尿病相关并发症的性别差异,却存在相互矛盾的证据。本研究旨在调查成年糖尿病患者中微血管和大血管并发症发生率的性别差异:这项前瞻性队列研究将澳大利亚 45 岁及以上研究的数据与行政健康记录联系起来。研究样本包括 25 713 名年龄≥45 岁的糖尿病患者(57% 为男性)。利用住院数据和医疗服务索赔确定了心血管疾病(CVD)、眼部、下肢和肾脏并发症的发病率。采用多变量考克斯比例危险模型评估性别与并发症发病率之间的关系:经年龄调整后,心血管疾病、眼部、下肢和肾脏并发症的每千人年发病率分别为 37、52、21 和 32。男性发生心血管疾病(调整后危险比 (aHR) 1.51,95% CI 1.43 至 1.59)、下肢并发症(aHR 1.47,95% CI 1.38 至 1.57)和肾脏并发症(aHR 1.55,95% CI 1.47 至 1.64)的风险高于女性,发生糖尿病视网膜病变的风险也高于女性(aHR 1.14,95% CI 1.03 至 1.26)。10 年间,分别有 44%、57%、25% 和 35% 的男性出现心血管疾病、眼部、下肢或肾脏并发症,而女性的这一比例分别为 31%、61%、18% 和 25%。糖尿病病程(结论:无论糖尿病病程长短,男性糖尿病患者发生并发症的风险都更高。男女患者的并发症发生率都很高,这凸显了从诊断开始就采取有针对性的并发症筛查和预防策略的重要性。
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来源期刊
Journal of Epidemiology and Community Health
Journal of Epidemiology and Community Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.10
自引率
0.00%
发文量
100
审稿时长
3-6 weeks
期刊介绍: The Journal of Epidemiology and Community Health is a leading international journal devoted to publication of original research and reviews covering applied, methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches. The journal aims to improve epidemiological knowledge and ultimately health worldwide.
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