In young and middle-aged adults, the presence of diabetes equalizes the risk of incident CAD between men and women (HR 0.89; 95% CI 0.43-1.83), whereas men have a higher risk without diabetes.
Cohort (n=11,517)
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Does the presence of diabetes alter the sex differences in incident coronary artery disease risk among healthy young and middle-aged adults?
While young and middle-aged women have a lower risk of CAD than men in the absence of diabetes, the presence of diabetes equalizes this risk, supporting aggressive CAD prevention strategies in women with diabetes.
Hazard Ratio: 0.89 (95% CI 0.43–1.83)
valor p: p=0.013 for interaction
OBJECTIVE: Controversy exists about the coronary artery disease (CAD) risk conveyed by diabetes in young and middle-aged women. We investigated sex differences in CAD by diabetes status among healthy individuals with different underlying risks of heart disease. RESEARCH DESIGN AND METHODS: We examined subjects aged 0.05. Adjusting for demographics, diabetes was associated with a significant four- to fivefold higher CAD rate among women in each cohort, without differences in men. In meta-analyses of three cohorts, additionally adjusted for BMI, smoking, hypertension, HDL, and non-HDL cholesterol, antihypertensive and cholesterol-lowering medication use, the hazard ratio of CAD in men versus women among nondiabetes was 2.43 (1.76-3.35) and diabetes was 0.89 (0.43-1.83); P = 0.013 interaction by diabetes status. CONCLUSIONS: Though young and middle-aged women are less likely to develop CAD in the absence of diabetes, the presence of diabetes equalizes the risk by sex. Our findings support aggressive CAD prevention strategies in women with diabetes and at similar levels to those that exist in men.
Kalyani et al. (Fri,) conducted a cohort in Healthy young and middle-aged adults (n=11,517). Male sex vs. Female sex was evaluated on Any CAD event during follow-up (fatal CAD in NHANES) (HR 0.89, 95% CI 0.43-1.83, p=0.013 for interaction). In young and middle-aged adults, the presence of diabetes equalizes the risk of incident CAD between men and women (HR 0.89; 95% CI 0.43-1.83), whereas men have a higher risk without diabetes.
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