Association of sex-specific differences in lipoprotein(a) concentrations with cardiovascular mortality in individuals with type 2 diabetes mellitus
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Association of sex-specific differences in lipoprotein(a) concentrations with cardiovascular mortality in individuals with type 2 diabetes mellitus. / Markus, Marcello Ricardo Paulista; Ittermann, Till; Schipf, Sabine; Bahls, Martin; Nauck, Matthias; Völzke, Henry; Santos, Raul Dias; Peters, Annette; Zeller, Tanja; Felix, Stephan Burkhard; Vasan, Ramachandran S; Thorand, Barbara; Steinhagen-Thiessen, Elisabeth; Dörr, Marcus.
in: CARDIOVASC DIABETOL, Jahrgang 20, Nr. 1, 168, 18.08.2021.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Association of sex-specific differences in lipoprotein(a) concentrations with cardiovascular mortality in individuals with type 2 diabetes mellitus
AU - Markus, Marcello Ricardo Paulista
AU - Ittermann, Till
AU - Schipf, Sabine
AU - Bahls, Martin
AU - Nauck, Matthias
AU - Völzke, Henry
AU - Santos, Raul Dias
AU - Peters, Annette
AU - Zeller, Tanja
AU - Felix, Stephan Burkhard
AU - Vasan, Ramachandran S
AU - Thorand, Barbara
AU - Steinhagen-Thiessen, Elisabeth
AU - Dörr, Marcus
N1 - © 2021. The Author(s).
PY - 2021/8/18
Y1 - 2021/8/18
N2 - BACKGROUND: Compared to individuals without type 2 diabetes mellitus, the relative increase in cardiovascular mortality is much higher in women than in men in individuals with type 2 diabetes mellitus.METHODS: We evaluated data from 7443 individuals (3792 women, 50.9%), aged 20 to 81 years, from two independent population-based investigations, SHIP-0 and MONICA/KORA S3. We analyzed the longitudinal sex-specific associations of lipoprotein(a) with cardiovascular mortality in individuals with and without type 2 diabetes mellitus using Cox regression.RESULTS: During a median follow-up of 20.5 years (136,802 person-years), 657 participants (404 men and 253 women) died of cardiovascular causes. Among individuals without type 2 diabetes mellitus, men had a significantly higher risk for cardiovascular mortality compared to women in unadjusted model and after adjustment. On the other hand, in participants with type 2 diabetes mellitus, the risk for cardiovascular mortality was not different between men and women in the unadjusted model and after adjustment for age, body mass index, low-density lipoprotein-cholesterol, fasting status and study sample (SHIP-0, MONICA/KORA S3). Further adjustment for lipoprotein(a) concentrations had no impact on the hazard ratio (HR) for cardiovascular mortality comparing men versus women in individuals without type 2 diabetes mellitus [HR: 1.94; 95% confidence interval (CI) 1.63 to 2.32; p < 0.001]. In individuals with type 2 diabetes mellitus, however, further adjustment for lipoprotein(a) led to an increased risk for cardiovascular mortality in men and a decreased risk in women resulting in a statistically significant difference between men and women (HR: 1.53; 95% CI 1.04 to 2.24; p = 0.029).CONCLUSIONS: Women are described to have a stronger relative increase in cardiovascular mortality than men when comparing individuals with and without type 2 diabetes mellitus. Higher lipoprotein(a) concentrations in women with type 2 diabetes mellitus than in men with type 2 diabetes mellitus might partially explain this finding.
AB - BACKGROUND: Compared to individuals without type 2 diabetes mellitus, the relative increase in cardiovascular mortality is much higher in women than in men in individuals with type 2 diabetes mellitus.METHODS: We evaluated data from 7443 individuals (3792 women, 50.9%), aged 20 to 81 years, from two independent population-based investigations, SHIP-0 and MONICA/KORA S3. We analyzed the longitudinal sex-specific associations of lipoprotein(a) with cardiovascular mortality in individuals with and without type 2 diabetes mellitus using Cox regression.RESULTS: During a median follow-up of 20.5 years (136,802 person-years), 657 participants (404 men and 253 women) died of cardiovascular causes. Among individuals without type 2 diabetes mellitus, men had a significantly higher risk for cardiovascular mortality compared to women in unadjusted model and after adjustment. On the other hand, in participants with type 2 diabetes mellitus, the risk for cardiovascular mortality was not different between men and women in the unadjusted model and after adjustment for age, body mass index, low-density lipoprotein-cholesterol, fasting status and study sample (SHIP-0, MONICA/KORA S3). Further adjustment for lipoprotein(a) concentrations had no impact on the hazard ratio (HR) for cardiovascular mortality comparing men versus women in individuals without type 2 diabetes mellitus [HR: 1.94; 95% confidence interval (CI) 1.63 to 2.32; p < 0.001]. In individuals with type 2 diabetes mellitus, however, further adjustment for lipoprotein(a) led to an increased risk for cardiovascular mortality in men and a decreased risk in women resulting in a statistically significant difference between men and women (HR: 1.53; 95% CI 1.04 to 2.24; p = 0.029).CONCLUSIONS: Women are described to have a stronger relative increase in cardiovascular mortality than men when comparing individuals with and without type 2 diabetes mellitus. Higher lipoprotein(a) concentrations in women with type 2 diabetes mellitus than in men with type 2 diabetes mellitus might partially explain this finding.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Biomarkers/blood
KW - Cardiovascular Diseases/blood
KW - Diabetes Mellitus, Type 2/blood
KW - Female
KW - Germany/epidemiology
KW - Health Status Disparities
KW - Humans
KW - Incidence
KW - Lipoprotein(a)/blood
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Prognosis
KW - Risk Assessment
KW - Risk Factors
KW - Sex Factors
KW - Time Factors
KW - Young Adult
U2 - 10.1186/s12933-021-01363-x
DO - 10.1186/s12933-021-01363-x
M3 - SCORING: Journal article
C2 - 34407812
VL - 20
JO - CARDIOVASC DIABETOL
JF - CARDIOVASC DIABETOL
SN - 1475-2840
IS - 1
M1 - 168
ER -