Higher risk of adverse cardiovascular outcomes in females with type 2 diabetes Mellitus: an Umbrella review of systematic reviews.

Autor:	Yaow CYL; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Chong B; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Chin YH; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Kueh MTW; Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, D02 YN77, Ireland.; University College Dublin Malaysia Campus, George Town, Malaysia., Ng CH; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Chan KE; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Tang ASP; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Chung C; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Goh R; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Kong G; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597., Muthiah M; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597.; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.; National University Centre for Organ Transplantation, National University Health System, Singapore., Sukmawati I; Cardiovascular Department, Siloam Hospitals Lippo Village, Pelita Harapan University, Tangerang, Indonesia., Lukito AA; National University Centre for Organ Transplantation, National University Health System, Singapore., Chan MY; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597.; Department of Cardiology, National University Heart Centre, National University Health System, Singapore., Khoo CM; Division of Endocrinology, Department of Medicine, National University Hospital, Singapore., Mehta A; VCU Health Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA., Mamas MA; Institute of Population Health, University of Manchester, Manchester, UK.; Keele Cardiac Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK., Dimitriadis GK; Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.; Obesity, Type 2 Diabetes and Immunometabolism Research Group, Department of Diabetes, Faculty of Cardiovascular Medicine & Sciences, School of Life Course Sciences, King's College London, London SE1 9RT, UK., Chew NWS; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597.; Cardiovascular Department, Siloam Hospitals Lippo Village, Pelita Harapan University, Tangerang, Indonesia.
Jazyk:	angličtina
Zdroj:	European journal of preventive cardiology [Eur J Prev Cardiol] 2023 Sep 06; Vol. 30 (12), pp. 1227-1235.
DOI:	10.1093/eurjpc/zwad133
Abstrakt:	Background: Previous studies have shown that females with type 2 diabetes mellitus (T2DM) may have excess mortality risk compared to their male counterparts. An important next step to address the high global burden of T2DM and cardiovascular disease (CVD) is an umbrella review to summarize data on sex differences in cardiovascular outcomes for patients with T2DM and assess the strength of the evidence observed. Methods and Results: Medline and Embase were searched from inception till 7 August 2022 for systematic reviews and meta-analyses studying the effects of sex on cardiovascular outcomes in T2DM patients. Results from reviews were synthesized with a narrative synthesis, with a tabular presentation of findings and forest plots for reviews that performed a meta-analysis. 27 review articles evaluating sex differences in cardiovascular outcomes were included. Females with T2DM had a higher risk of developing coronary heart disease (CHD; RRR: 1.52, 95%CI: 1.32-1.76, P < 0.001), acute coronary syndrome (ACS; RRR: 1.38, 95%CI: 1.25-1.52, P < 0.001), heart failure (RRR: 1.09, 95%CI: 1.05-1.13, P < 0.001) than males. Females had a higher risk of all-cause mortality (RRR: 1.13, 95%CI: 1.07-1.19, P < 0.001), cardiac mortality (RRR: 1.49, 95%CI: 1.11-2.00, P = 0.009) and CHD mortality (RRR: 1.44, 95%CI: 1.20-1.73, P < 0.001) as compared to males. Conclusions: This umbrella review demonstrates that females with T2DM have a higher risk of cardiovascular outcomes than their male counterparts. Future research should address the basis of this heterogeneity and epidemiological factors for better quality of evidence, and identify actionable interventions that will narrow these sex disparities. Competing Interests: Conflicts of interest: Mark Y. Chan: Speaker’s fees and research grants Astra Zeneca, Abbott Technologies and Boston Scientific. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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