2型糖尿病における心血管リスクとリスクファクター管理: 性差を評価する人口ベースのコホート研究
Alison K Wright1,2, Evangelos Kontopantelis3, Richard Emsley4
1Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Manchester Academic Health Sciences Centre (A.K.W., D.M.A.).
Circulation
|April 16, 2019
まとめ
2型糖尿病 (T2DM) の女性は男性と同様の心血管疾患のリスク増加に直面しますが,リスク因子管理と処方薬の格差を示し,公平なケアの必要性を強調しています.
科学分野:
- 心臓病科
- 内分泌学
- 公衆衛生
背景:
- 糖尿病の治療における英国の臨床実務の最近の変化は,性差に関する最新のデータを必要としています.
- 2型糖尿病 (T2DM) の心血管リスクと管理の現代的な見積もりが必要です.
研究 の 目的:
- イギリスのT2DM患者における 心血管リスクとリスクファクター管理における 性差を評価する.
- T2DMの男性と女性の心血管疾患リスクと処方パターンを比較する.
主な方法:
- 病院と死亡記録にリンクされた臨床実務研究データリンクを用いた遡及コホート研究.
- 診断された79,985人のT2DM患者 (2006年−2013年) は,糖尿病のない386,547人の対照群と一致した.
- 性別別別Coxモデルを用いて心血管疾患のリスクを評価した.
主要な成果:
- T2DMの女性は,T2DMのない女性と比較して心血管疾患のリスクが高く (aHR 1. 20),T2DMの男性は同様のリスク増加を示した (HR 1. 12).
- T2DMの女性では相対的な心血管リスクの増加が非有意であった (RR1. 07).
- T2DMの女性は肥満,高血圧,高コレステロール症になる可能性が高く,特に心血管疾患の場合は,脂質低下薬とACE阻害剤を受ける可能性が低い.
結論:
- T2DMの女性では,T2DMの男性と比較して,心血管疾患の相対的なリスクが著しく増加することはありません.
- T2DMの危険因子管理のための薬剤の処方において,重要な性格差が残っています.
- このような処方差は,男女ともに公平で高品質な糖尿病の治療を確保するための努力を強化することを必要としています.
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