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Diabetes-related coronary risk higher in women than men
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In patients with diabetes, the likelihood of developing coronary heart disease differs based on gender, with women at increased risk compared with men, according to a review published in Diabetologia. However, more research is needed to determine why.
The disparities were reported by Sanne A. E. Peters, PhD, of the University of Cambridge, United Kingdom, and the University Medical Center Utrecht, the Netherlands, and two colleagues through a meta-analysis of data from the past 50 years. The researchers investigated 64 prospective population-based cohort studies with 858,507 adults and 28,203 incident CHD events, making this the largest study of its kind, according to the researchers.
The criteria for eligible studies were reported RR estimates for CHD related to diabetes, with variability adjusted for at least age. Meta-analyses including inverse variance weighting were used to gather gender-specific RRs and the RR ratio (women-to-men) to determine any effects of gender difference for diabetes relating to subsequent risk of CHD
The RR for incident CHD in adults with diabetes compared with those without diabetes was 2.82 (95% CI, 2.35-3.38) in women and 2.16 (95% CI, 1.82-2.56) in men. The multiple-adjusted RR ratio for incident CHD was 44% greater in women with diabetes vs. men with the condition (RR ratio=1.44; 95% CI, 1.27-1.63). There were no significant heterogeneity between studies and heightened risk factors, and a relative lack of treatment in women would not account for the excess risk, according to the study findings.
“We propose that a greater deterioration in cardiovascular risk profile combined with more prolonged exposure to adverse levels of cardiovascular risk factors among pre-diabetic women compared with their male equivalents, possibly driven by greater levels of adiposity, may be responsible for the excess risk of diabetes-related CHD in women,” the researchers wrote.
“Further studies are warranted to determine the actual mechanisms responsible for the difference in diabetes-related coronary risk between the sexes.”
Disclosure: One of the researchers is supported by a Niels Stensen Fellowship.
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Peters SAE. Diabetologia. 2014;doi:10.1007/s00125-014-3260-6.
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