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在患有2型糖尿病的女性中,未能控制常规心血管风险因素可能解释了较差的死亡率
Michael Stedman1, Martin B Whyte2, Ian Laing3
1Res Consortium, Andover, Hampshire, UK.
Diabetes/metabolism research and reviews
|August 18, 2023
概括
患有2型糖尿病的女性的结果比男性更糟糕,这与较高的风险因素率和较少的心脏保护药物有关. 解决这些差异可以减少糖尿病护理中的过度女性死亡率.
科学领域:
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 英国糖尿病患者的标准化死亡率 (SMR) 较高 (1.5-1.7),观察到基于性别的结果差异.
- 有限的研究已经探索了影响糖尿病死亡率这些差异的因素.
研究的目的:
- 调查2型糖尿病 (T2D) 患者死亡率和预期寿命的性别差异.
- 为了确定临床和与治疗相关的因素,有助于T2D的基于性别的结果变化.
主要方法:
- 来自英格兰萨尔福德 (2010-2020) 的T2D患者数据的回顾性分析.
- 调整为多重贫困指数 (SMRd) 和每人死亡平均寿命 (LEYLD) 的 SMR 的计算.
- 单变量和多变量分析检查了治疗和临床特征对SMRd相对于性别的影响.
主要成果:
- 分析包括11,806名患者 (5184名女性,6622名男性);记录了3921例死亡.
- 总的来说,SMRd为1.51,女性的发病率 (1.60) 比男性 (1.44) 高.
- 女性的65岁以上诊断的患病率更高,低于eGFR (<60),心脏保护药物的处方减少 (ACE抑制剂/ARB,DPP4抑制剂,SGLT2抑制剂).
结论:
- 与男性相比,患有2型糖尿病的女性体验的结果较差.
- 较高的不良风险因素流行率和较少使用心脏保护药物有助于增加女性死亡率.
- 据估计,T2D中超过55%的女性死亡可能归因于风险因素患病率和药物处方的性别差异.
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