Gender Difference in Albuminuria and Ischemic Heart Disease in Type 2 Diabetes
Clinical Medicine & Research, 05/17/2012
Nakhjavani M et al. – Men with albuminuria are at increased risk of ischemic heart disease compared to women. This may be related to the role of high–density lipoprotein on the albuminuria–gender relationship.
- The authors designed a matched case–control study of 926 patients with albuminuria (cases) and 926 age and body mass index matched patients without albuminuria (controls).
- Ischemic heart disease was defined as the presence of (1) history of angina pectoris or angina equivalent symptoms and critical care unit admission, (2) myocardial infarction and/or electrocardiographic evidence of Q–wave myocardial infarction, (3) coronary revascularization and/or stenting, (4) positive myocardial single–photon emission computed tomography scan, (5) ischemic ST–segment or T–wave changes, and (6) positive stress testing.
- Patients with albuminuria had a lower glomerular filtration rate and a longer diabetes duration than patients without albuminuria.
- In the group of cases, there were a greater number of men with ischemic heart disease (120 of 370; 32.4%) compared to women (97 of 559; 17.4%) (P<0.001).
- The odds ratio of having ischemic heart disease according to the presence or absence of albuminuria was 1.25 [95% CI: 1.01–1.56] (P<0.05) in all studied populations, 0.79 [95% CI: 0.51–1.21] (P=0.14) in women, and 2.84 [95% CI: 1.68–4.79] (P<0.001) in men.
- The authors showed that diabetes duration, high–density lipoprotein, low–density lipoprotein, and hemoglobin A1c influence albuminuria in women, while diabetes duration, fasting blood sugar, and diastolic blood pressure influence albuminuria in men.