PDF(Pubmed)
Abstract：
BACKGROUND: The global prevalence of diabetes is similar in men and women; however, there is conflicting evidence regarding sex differences in diabetes-related complications. The aim of this study was to investigate sex differences in incident microvascular and macrovascular complications among adults with diabetes.
METHODS: This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study sample included 25 713 individuals (57% men), aged ≥45 years, with diabetes at baseline. Incident cardiovascular disease (CVD), eye, lower limb, and kidney complications were determined using hospitalisation data and claims for medical services. Multivariable Cox proportional hazards models were used to assess the association between sex and incident complications.
RESULTS: Age-adjusted incidence rates per 1000 person years for CVD, eye, lower limb, and kidney complications were 37, 52, 21, and 32, respectively. Men had a greater risk of CVD (adjusted hazard ratio (aHR) 1.51, 95% CI 1.43 to 1.59), lower limb (aHR 1.47, 95% CI 1.38 to 1.57), and kidney complications (aHR 1.55, 95% CI 1.47 to 1.64) than women, and a greater risk of diabetic retinopathy (aHR 1.14, 95% CI 1.03 to 1.26). Over 10 years, 44%, 57%, 25%, and 35% of men experienced a CVD, eye, lower limb, or kidney complication, respectively, compared with 31%, 61%, 18%, and 25% of women. Diabetes duration (<10 years vs ≥10 years) had no substantial effect on sex differences in complications.
CONCLUSIONS: Men with diabetes are at greater risk of complications, irrespective of diabetes duration. High rates of complications in both sexes highlight the importance of targeted complication screening and prevention strategies from diagnosis.
METHODS: This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study sample included 25 713 individuals (57% men), aged ≥45 years, with diabetes at baseline. Incident cardiovascular disease (CVD), eye, lower limb, and kidney complications were determined using hospitalisation data and claims for medical services. Multivariable Cox proportional hazards models were used to assess the association between sex and incident complications.
RESULTS: Age-adjusted incidence rates per 1000 person years for CVD, eye, lower limb, and kidney complications were 37, 52, 21, and 32, respectively. Men had a greater risk of CVD (adjusted hazard ratio (aHR) 1.51, 95% CI 1.43 to 1.59), lower limb (aHR 1.47, 95% CI 1.38 to 1.57), and kidney complications (aHR 1.55, 95% CI 1.47 to 1.64) than women, and a greater risk of diabetic retinopathy (aHR 1.14, 95% CI 1.03 to 1.26). Over 10 years, 44%, 57%, 25%, and 35% of men experienced a CVD, eye, lower limb, or kidney complication, respectively, compared with 31%, 61%, 18%, and 25% of women. Diabetes duration (<10 years vs ≥10 years) had no substantial effect on sex differences in complications.
CONCLUSIONS: Men with diabetes are at greater risk of complications, irrespective of diabetes duration. High rates of complications in both sexes highlight the importance of targeted complication screening and prevention strategies from diagnosis.
摘要：
背景：全球糖尿病患病率在男性和女性中相似；然而，关于糖尿病相关并发症的性别差异存在相互矛盾的证据.这项研究的目的是调查糖尿病成人中微血管和大血管并发症的性别差异。
方法：这项前瞻性队列研究将45及以上研究的数据联系起来，澳大利亚,到行政健康记录。研究样本包括25713个人（57％的男性），年龄≥45岁，基线时患有糖尿病。心血管疾病（CVD），眼睛,下肢,和肾脏并发症是使用住院数据和医疗服务索赔确定的。多变量Cox比例风险模型用于评估性别与事件并发症之间的关联。
结果：年龄调整后的CVD每1000人年发病率，眼睛,下肢,和肾脏并发症分别为37、52、21和32。男性患CVD的风险更高（校正风险比（aHR）1.51，95%CI1.43至1.59），下肢（AHR1.47，95%CI1.38至1.57），和肾脏并发症（aHR1.55，95%CI1.47至1.64）比女性，和糖尿病视网膜病变的风险更大（aHR1.14，95％CI1.03至1.26）。超过10年,44%,57%,25%,35%的男性经历过心血管疾病，眼睛,下肢,或肾脏并发症，分别,与31%相比，61%,18%,25%的女性。糖尿病病程（<10年vs≥10年）对并发症的性别差异没有实质性影响。
结论：男性糖尿病患者有更大的并发症风险，无论糖尿病的持续时间。男女并发症发生率高，突出了针对性并发症筛查和诊断预防策略的重要性。
方法：这项前瞻性队列研究将45及以上研究的数据联系起来，澳大利亚,到行政健康记录。研究样本包括25713个人（57％的男性），年龄≥45岁，基线时患有糖尿病。心血管疾病（CVD），眼睛,下肢,和肾脏并发症是使用住院数据和医疗服务索赔确定的。多变量Cox比例风险模型用于评估性别与事件并发症之间的关联。
结果：年龄调整后的CVD每1000人年发病率，眼睛,下肢,和肾脏并发症分别为37、52、21和32。男性患CVD的风险更高（校正风险比（aHR）1.51，95%CI1.43至1.59），下肢（AHR1.47，95%CI1.38至1.57），和肾脏并发症（aHR1.55，95%CI1.47至1.64）比女性，和糖尿病视网膜病变的风险更大（aHR1.14，95％CI1.03至1.26）。超过10年,44%,57%,25%,35%的男性经历过心血管疾病，眼睛,下肢,或肾脏并发症，分别,与31%相比，61%,18%,25%的女性。糖尿病病程（<10年vs≥10年）对并发症的性别差异没有实质性影响。
结论：男性糖尿病患者有更大的并发症风险，无论糖尿病的持续时间。男女并发症发生率高，突出了针对性并发症筛查和诊断预防策略的重要性。
