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May 22, 2023Biology of Sex Differences18 citationsOpen Access

Sex differences in cardiovascular risk, lifestyle, and psychological factors in patients with type 2 diabetes: the Fukuoka Diabetes Registry

TOToshiaki OhkumaMIMasanori IwaseHFHiroki Fujii

Key Result

Women with type 2 diabetes were significantly less likely than men to achieve the recommended HbA1c target of <7.0% (OR 0.71) and had worse control of LDL-C and obesity indices.

Study Design

Type

Cross-Sectional (n=4,923)

Multicenter

Yes

Structured PICO

Are there sex differences in the control of cardiovascular risk factors, lifestyle, and psychological factors in Japanese patients with type 2 diabetes?

P
Population
4,923 Japanese outpatients with type 2 diabetes aged 20 years and older, evaluated for sex differences in cardiovascular risk, lifestyle, and psychological factors.
E
Exposure
Female sex (observational)
C
Comparator
Male sex (observational)
O
Outcome
Levels of cardiovascular risk factors (HbA1c, BP, lipids, anthropometric indices) and lifestyle and psychological factors, and the proportions of participants who achieved recommended ranges for these factors.surrogate

In Japanese patients with type 2 diabetes, women are significantly less likely than men to achieve recommended targets for HbA1c, LDL-C, and obesity indices, highlighting the need for sex-specific management strategies.

Main Result

Odds Ratio: 0.71 (95% CI 0.64–0.8)

Absolute Event Rate: 34.3% vs 42%

Limitations

  • All participants were recruited from Japan, limiting generalizability to other regional and ethnic populations.
  • No information on adherence to medical treatment was available.
  • Single measurement of blood pressure may have resulted in misclassification.
  • Information on potential residual confounding factors, such as educational and economic backgrounds, was not included.
  • The cross-sectional design limits any inference of a cause-and-effect relationship.
  • Generalizability limited to Japanese population
  • No information on adherence to medical treatment
  • Single measurement of BP may have resulted in misclassification
  • Lack of information on potential residual confounding factors such as educational and economic backgrounds
  • Cross-sectional design limits inference of a cause-and-effect relationship

Abstract

BACKGROUND: The excess risk of cardiovascular diseases associated with diabetes is greater in women than in men. The present study aimed to examine sex differences in the control of cardiovascular risk factors, as well as lifestyle and psychological factors, in patients with type 2 diabetes. METHODS: A total of 4923 Japanese patients with type 2 diabetes were included in this cross-sectional study. Female/male differences in cardiovascular risk factor levels, and corresponding odds ratios for achieving recommended ranges for preventing cardiovascular diseases and having unhealthy lifestyle and psychological factors were computed by linear and logistic regression models. RESULTS: Women were less likely than men to achieve recommended ranges for glycated hemoglobin, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and obesity-related anthropometric indices such as body mass index and waist circumference, but were more likely than men to be on target for high-density lipoprotein cholesterol and triglycerides. Women were also more likely than men to have an unhealthy lifestyle and psychological factors, including less dietary fiber intake, less leisure-time physical activity, shorter sleep duration, more constipation, and more depressive symptoms. Similar findings were observed when the participants were subgrouped by age (< 65 and ≥ 65 years) and past history of cardiovascular disease. CONCLUSIONS: We observed significant sex differences for a range of cardiovascular risk factors, as well as lifestyle and psychological factors, suggesting the importance of adopting a sex-specific approach for the daily clinical management of diabetes.

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Cite This Study

Ohkuma et al. (2023) conducted a cross-sectional in Type 2 diabetes (n=4,923). Female sex vs. Male sex was evaluated on Achievement of recommended HbA1c range (< 7.0%) (OR 0.71, 95% CI 0.64-0.80). Women with type 2 diabetes were significantly less likely than men to achieve the recommended HbA1c target of <7.0% (OR 0.71) and had worse control of LDL-C and obesity indices.

synapsesocial.com/papers/6a5368328be65f8c3a906b4dhttps://doi.org/10.1186/s13293-023-00517-8
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