Sophie C de Ruiter, Lena Tschiderer, Diederick E Grobbee, Ynte M Ruigrok, Peter Willeit, Hester M den Ruijter, A Floriaan Schmidt, Sanne A E Peters
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引用次数: 0
摘要
导读：观察性研究表明，2型糖尿病与心血管疾病（CVD）之间的相关性在女性中强于男性。目前尚不清楚糖尿病和血糖特征对心血管疾病的因果影响是否在女性和男性之间也有所不同。方法：我们在UK Biobank中进行了性别分层观察和孟德尔随机化（MR）分析，以研究2型糖尿病和HbA1c与CVD结局（合并CVD、冠心病、心肌梗死、中风、缺血性中风、脑出血和蛛网膜下腔出血）的性别特异性关联。作为次要分析，我们进行了性别分层的MR，以研究基因代理的空腹血糖和胰岛素与CVD结果的关系。结果：在观察性分析中，糖尿病与女性冠心病的额外风险大于男性（男女风险比为1.11 [95% CI 1.03, 1.21]）。HbA1c与CVD结果的相关性在两性中相似。在MR中，女性和男性患糖尿病和冠心病的遗传易感性之间的关系相似（男女比值比0.98 [95% CI 0.91, 1.05]）。在观察和磁共振分析中，没有发现糖尿病和中风之间存在性别差异。此外，女性和男性的HbA1c、空腹血糖和空腹胰岛素的MR结果相似。结论：本研究提示糖尿病和血糖特征对CVD的因果影响在女性和男性中相似。
Diabetes, glycaemic traits and cardiovascular disease in females and males: Observational and Mendelian randomisation analyses in the UK Biobank.
Introduction: Observational studies have shown that the association between type 2 diabetes and cardiovascular disease (CVD) is stronger in females than in males. It remains unclear whether the causal effects of diabetes and glycaemic traits on CVD are also different between females and males.
Methods: We performed sex-stratified observational and Mendelian randomisation (MR) analyses in the UK Biobank to investigate the sex-specific associations of type 2 diabetes and HbA1c with CVD outcomes (combined CVD, coronary heart disease [CHD], myocardial infarction, stroke, ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage). As secondary analyses, we performed sex-stratified MR for the association of genetically proxied fasting glucose and insulin with CVD outcomes.
Results: In observational analysis, diabetes was associated with a greater excess risk for CHD in females than in males (female-to-male ratio of hazard ratios 1.11 [95% CI 1.03, 1.21]). The association of HbA1c with CVD outcomes was similar in both sexes. In MR, the relationship between genetic liability to diabetes and CHD was similar in females and males (female-to-male ratio of odds ratios 0.98 [95% CI 0.91, 1.05]). No sex differences were found for the association between diabetes and stroke in both observational and MR analyses. Moreover, MR results on HbA1c, fasting glucose and fasting insulin were similar for females and males.
Conclusion: This study suggests that causal effects of diabetes and glycaemic traits on CVD are similar in females and males.
期刊介绍：
Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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