Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study
在大辛辛那提/北肯塔基脑卒中研究中合并糖尿病的缺血性脑卒中患者心血管危险因素的性别差异
Abstract
enBackground
The aim of the present study was to compare sex-specific associations between cardiovascular risk factors and diabetes mellitus (DM) among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS).
Methods
The GCNKSS ascertained AIS cases in 2005 and 2010 among adult (age ≥ 20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors were compared between those with and without DM using Chi-squared tests and multiple logistic regression analysis to examine sex-specific profiles.
Results
There were 3515 patients with incident AIS; 1919 (55%) were female, 697 (20%) were Black, and 1146 (33%) had DM. Among both women and men with DM, significantly more were obese and had hypertension, high cholesterol, and coronary artery disease (CAD) compared with those without DM. For women with AIS, multivariable sex-specific adjusted analyses revealed that older age was associated with decreased odds of having DM (adjusted odds ratio [aOR] 0.88, 95% confidence interval [CI] 0.80–0.98). For women with CAD, the odds of DM were increased (aOR 1.76, 95% CI 1.33–2.32). Age and CAD were not significant factors in differentiating the profiles of men with and without DM.
Conclusions
Women with DM had strokes at a younger age, whereas no such age difference existed in men. Compared with men, women with DM were also more likely to have CAD than those without DM, suggesting a sex difference in the association between DM and vascular disease. These findings may suggest a need for more aggressive risk factor management in diabetic women.
摘要
zh背景
当前这项研究旨在大辛辛那提/北肯塔基卒中研究(Greater Cincinnati/Northern Kentucky Stroke Study, GCNKSS)期间合并急性缺血性脑卒中(acute ischemic stroke, AIS)的患者中调查心血管危险因素与糖尿病之间性别特异性的相关性。
方法
GCNKSS研究于2005年及2010年在代表了两个人种的一百三十万名成年(年龄≥ 20岁)居民人群中确诊了AIS病例。为了明确哪些是性别特异的特征, 在合并与不合并糖尿病的患者之间使用卡方检验与多元logistic回归分析, 比较过去以及当前的卒中危险因素。
结果
有3515名患者发生了AIS;其中1919名(55%)为女性, 697名(20%)为黑种人, 并且有1146名(33%)合并糖尿病。合并糖尿病的女性以及男性患者与不合并糖尿病的患者相比, 他们合并肥胖、高血压、高胆固醇以及冠心病的比例显著更高。对于合并AIS的女性来说, 经过性别特异性校正后的多变量分析结果表明, 年龄越大合并糖尿病的几率越低(校正后危险比[aOR]为0.88, 95%置信区间[CI]为0.80-0.98)。对于合并冠心病的女性来说, 合并糖尿病的危险比升高(aOR为1.76, 95% CI为1.33-2.32)。年龄与冠心病都不是辨别男性合并或者不合并糖尿病的显著性因素。
结论
合并糖尿病的女性出现中风时的年龄更小, 但是男性没有这种年龄差异。与男性相比, 合并糖尿病的女性与不合并糖尿病的女性相比更容易出现冠心病, 这表明糖尿病与血管疾病之间的关系存在性别差异。这些研究结果提示我们需要更积极地管理女性糖尿病患者的危险因素。
