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The impact of sex on risk of cardiovascular disease and all-cause mortality in adults with or without diabetes mellitus: A comparison between the U.S. and Japan

Authors :
Naoyuki Takashima
Hisatomi Arima
Katsuyuki Miura
Zuolu Liu
Longjian Liu
Tomonori Okamura
Edward J. Gracely
Naoko Miyagawa
Aya Kadota
Hirotsugu Ueshima
Akira Fujiyoshi
Akira Okayama
Takayoshi Ohkubo
Fuzhong Xue
Source :
Journal of Diabetes and its Complications. 33:417-423
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

Aims To test a hypothesis that women with diabetes mellitus (DM) versus those without DM had a significantly higher risk of heart disease (HD), stroke and all-cause mortality than their male counterparts in the U.S. as well as in Japan. Methods We analyzed two nationally representative datasets, one from the U.S. NHANES III cohort (n = 13,169), and the other from the Japan NIPPON DATA90 cohort (n = 7445). Hazard ratios (HRs) of DM for risk of mortality and sex-DM interaction effect on mortality were analyzed prospectively using Cox's proportional hazards regression models. Results Patients with DM had significantly higher mortality from HD, stroke and all-cause mortality in the U.S. and in Japan. However, the HRs of DM versus non-DM for HD and all-cause mortality were significantly higher in women compared to men in the U.S. (sex-DM interaction: HR = 1.59, p = 0.01, and 1.24, p = 0.045 for HD and all-cause mortality), but the sex-DM interaction effect was not statistically significant in the Japanese cohort. Discussion Patients with DM had a significantly higher risk of mortality than those without DM in the U.S. and Japan. However, women with DM versus those without DM had a higher relative risk of HD and all-cause mortality than their counterparts in men in the U.S, but this sex difference by DM status was not observed in the Japanese cohort. Whether the sex-difference effect of DM on HD and all-cause mortality is due to a difference in metabolic disorders between the two populations warrants consideration and further studies.

Details

ISSN :
10568727
Volume :
33
Database :
OpenAIRE
Journal :
Journal of Diabetes and its Complications
Accession number :
edsair.doi.dedup.....1558fc997eda1dfacd0733ec98966c89