性别差异对糖尿病患者心脑终点事件的影响

目的比较不同性别对高血糖／糖尿病人群新发临床终点事件的影响。方法本研究采用前瞻性队列研究方法，以参加2006年7月-2007年10月健康查体的101510名开滦集团职工中空腹血糖≥7．0mmol／L或〈7．0mmol／L但已确诊为糖尿病，正在使用降糖药物的8302例高血糖／糖尿病者作为观察队列，随访38～53（48．01±3．14）个月，随访期间每半年收集一次新发心脑血管事件情况。分析性别差异对高血糖／糖尿病人群新发心脑血管事件的影响。结果①与男性患者相比，女性患者体质量指数（MBI）、TC、HDI。较高，而LDL、DBP较低，差异有统计学意义（P〈0．05），且女性患者吸烟人数明显少于男性患者（P〈0．05）。②随访期间内共发生心脑血管事件374例（有发生两次或以上事件者，统计总心脑血管事件时只记为1次，以最先发生终点事件的时间和事件为结局）。其中男性组发生总事件322例（4．72％）、脑梗死200例（2．93％），全因死亡250例（3．66％）；女性组发生总事件52例（3．52％）、脑梗死29例（1．96％），全因死亡34例（2．30％），差异有统计学意义（P〈0．05）。③多变量Cox比例风险回归分析表明，性别的相对危险最高，相对于女性组，男性组总事件、脑梗死及全因死亡RR值分别增加1．35倍（95％Cj：1．01～1．81，P〈0．05）、1．52倍（95％CI：1．03～2．25，P〈0．05）、1．64倍（95％CI：1．13～2．36，P〈0．05）。结论男性糖尿病患者心脑终点事件的发生率高于女性患者。

THE EFFECT OF DIFFERENT GENDERS ON CARDIO- CEREBRAL VASCULAR EVENTS IN DIABETIC POPULATION

Objective To study the effect of different genders on cardio-cerebral vascular events in the population with hyperglycemia or diabetes. Methods This was a prospective cohort study. In a total of 101510 employees who had been carried out a healthy examination in Kailuan Group in the period of July 2006 to October 2007, 8302 subjects were selected who determined fasting plasma glucose ≥ 7.0mmol/L or who were using insulin or hypoglycemic drugs and fasting plasma glucose 〈 7.0mmol/L as the observation population, and followed up 38-53（48. 01± 3.14） months to collect the clinical endpoint. The effect of different genders were observed on cardio- cerebrovascular events in the population with hyperglycemia or diabetes. Results Baseline data were analyzed between the two groups, body mass index（ BMI）, TC, HDL in female group were higher than those in male group（P〈0.05）, LDL, DBP, the number of smokers in 5emale group were lower than those in male group（P〈0. 05）. During the period of follow- up, there were a total of 374 eases cardioeerebrovascular events, in which 322 cases （4.72%） of total cardiocer- ebral vascular events, 200 cases （2.93%） of cerebral infarction and 250 cases （3.66% ） of all - cause mortality occurred in male group and 52 eases （3.52%）, 29 cases （1.96%A） ,34 cases（2.30%）in female group. The differences were significant [P〈0. 05）. A multivariate Cox＇s proportional hazards regression model showed that the male group had an increased risk of total eardiocerebral vascular events （RR was 1.35, 95%CI was 1.01-1.81）, cerebral infarction （RR was 1.52, 95%CI was1.03-2.25）, all- cause mortality （RR was 1.64, 95%CI was 1.13-2.36） compared with those in the female groups. Conclusion The incidence rate of total cardio- cerebral vascular events in the male diabetic population is higher than that in the female group.