Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study
Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study
Aim
To examine possible sex differences in the excess risk of myocardial infarction (MI) consequent to a range of conventional risk factors in a large-scale international cohort of patients with diabetes, and to quantify these potential differences both on the relative and absolute scales.
Materials and methods
Eleven thousand and sixty-five participants (42% women) with type 2 diabetes in the ADVANCE trial and its post-trial follow-up study, ADVANCE-ON, were included. Cox regression models were used to estimate hazard ratios (HRs) for associations between risk factors and MI (fatal and non-fatal) by sex, and the women-to-men ratio of HRs (RHR).
Results
Over a median of 9.6 years of follow-up, 719 patients experienced MI. Smoking status, smoking intensity, higher systolic blood pressure (SBP), HbA1c, total and LDL cholesterol, duration of diabetes, triglycerides, body mass index (BMI) and lower HDL cholesterol were associated with an increased risk of MI in both sexes. Furthermore, some variables were associated with a greater relative risk of MI in women than men: RHRs were 1.75 (95% CI: 1.05-2.91) for current smoking, 1.53 (1.00-2.32) for former smoking, 1.18 (1.02-1.37) for SBP, and 1.13 (95% CI, 1.003-1.26) for duration of diabetes. Although incidence rates of MI were higher in men (9.3 per 1000 person-years) compared with women (5.8 per 1000 person-years), rate differences associated with risk factors were greater in women than men, except for HDL cholesterol and BMI.
Conclusions
In patients with type 2 diabetes, smoking, higher SBP and longer duration of diabetes had a greater relative and absolute effect in women than men, highlighting the importance of routine sex-specific approaches and early interventions in women with diabetes.
84-92
Zengin, Ayse
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Breasail, Micheal O.
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Parsons, Camille
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Jarjou, Landing M.
ca2935b3-3c0d-4541-bff7-afd191cf502b
Janha, Ramatoulie E.
1a14cb0a-33f3-47f7-8da4-3f7e431d555e
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ebeling, Peter R.
71a1d109-c0fe-438d-9d01-660012eb7049
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
1 February 2023
Zengin, Ayse
b2023a08-983d-45bc-ba35-02b5e08aaaa3
Breasail, Micheal O.
91913ba1-a694-4365-80f0-dc253cc025c2
Parsons, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Jarjou, Landing M.
ca2935b3-3c0d-4541-bff7-afd191cf502b
Janha, Ramatoulie E.
1a14cb0a-33f3-47f7-8da4-3f7e431d555e
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ebeling, Peter R.
71a1d109-c0fe-438d-9d01-660012eb7049
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Zengin, Ayse, Breasail, Micheal O., Parsons, Camille, Jarjou, Landing M., Janha, Ramatoulie E., Prentice, Ann, Cooper, Cyrus, Ebeling, Peter R. and Ward, Kate
(2023)
Sex-specific associations between cardiovascular risk factors and physical function: The Gambian Bone and Muscle Ageing Study.
Journal of Cachexia, Sarcopenia and Muscle, 14 (1), .
(doi:10.1002/jcsm.13069).
Abstract
Aim
To examine possible sex differences in the excess risk of myocardial infarction (MI) consequent to a range of conventional risk factors in a large-scale international cohort of patients with diabetes, and to quantify these potential differences both on the relative and absolute scales.
Materials and methods
Eleven thousand and sixty-five participants (42% women) with type 2 diabetes in the ADVANCE trial and its post-trial follow-up study, ADVANCE-ON, were included. Cox regression models were used to estimate hazard ratios (HRs) for associations between risk factors and MI (fatal and non-fatal) by sex, and the women-to-men ratio of HRs (RHR).
Results
Over a median of 9.6 years of follow-up, 719 patients experienced MI. Smoking status, smoking intensity, higher systolic blood pressure (SBP), HbA1c, total and LDL cholesterol, duration of diabetes, triglycerides, body mass index (BMI) and lower HDL cholesterol were associated with an increased risk of MI in both sexes. Furthermore, some variables were associated with a greater relative risk of MI in women than men: RHRs were 1.75 (95% CI: 1.05-2.91) for current smoking, 1.53 (1.00-2.32) for former smoking, 1.18 (1.02-1.37) for SBP, and 1.13 (95% CI, 1.003-1.26) for duration of diabetes. Although incidence rates of MI were higher in men (9.3 per 1000 person-years) compared with women (5.8 per 1000 person-years), rate differences associated with risk factors were greater in women than men, except for HDL cholesterol and BMI.
Conclusions
In patients with type 2 diabetes, smoking, higher SBP and longer duration of diabetes had a greater relative and absolute effect in women than men, highlighting the importance of routine sex-specific approaches and early interventions in women with diabetes.
Text
JCSM_FINAL_R1
- Accepted Manuscript
More information
Accepted/In Press date: 24 July 2022
e-pub ahead of print date: 8 November 2022
Published date: 1 February 2023
Identifiers
Local EPrints ID: 469018
URI: http://eprints.soton.ac.uk/id/eprint/469018
ISSN: 2190-5991
PURE UUID: 885ee283-1a29-4e03-b352-d13465ee2fda
Catalogue record
Date deposited: 05 Sep 2022 16:42
Last modified: 09 Feb 2023 02:52
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Contributors
Author:
Ayse Zengin
Author:
Micheal O. Breasail
Author:
Camille Parsons
Author:
Landing M. Jarjou
Author:
Ramatoulie E. Janha
Author:
Ann Prentice
Author:
Peter R. Ebeling
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