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Markus, M.R.P.* ; Ittermann, T.* ; Schipf, S.* ; Bahls, M.* ; Nauck, M.* ; Völzke, H.* ; Santos, R.D.* ; Peters, A. ; Zeller, T.* ; Felix, S.B.* ; Vasan, R.S.* ; Thorand, B. ; Steinhagen-Thiessen, E.* ; Dörr, M.*

Association of sex-specific differences in lipoprotein(a) concentrations with cardiovascular mortality in individuals with type 2 diabetes mellitus.

Cardiovasc. Diabetol. 20:168 (2021)
Verlagsversion DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
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.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Cardiovascular Mortality ; Dyslipidemia ; Lipoprotein(a) ; Sex-specific ; Type 2 Diabetes Mellitus; Coronary-heart-disease; Myocardial-infarction; Insulin-resistance; Metabolic Syndrome; Risk-factor; 64 Cohorts; Men; Health; Population; Impact
Sprache englisch
Veröffentlichungsjahr 2021
HGF-Berichtsjahr 2021
ISSN (print) / ISBN 1475-2840
e-ISSN 1475-2840
Zeitschrift Cardiovascular Diabetology
Quellenangaben Band: 20, Heft: 1, Seiten: , Artikelnummer: 168 Supplement: ,
Verlag Bmc
Verlagsort Campus, 4 Crinan St, London N1 9xw, England
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Epidemiology (EPI)
POF Topic(s) 30202 - Environmental Health
Forschungsfeld(er) Genetics and Epidemiology
PSP-Element(e) G-504000-002
G-504000-010
G-504090-001
Förderungen State of Bavaria
German Competence Network Heart Failure
German Federal Ministry of Education and Research (BMBF)
Helmholtz Zentrum Munchen (German Research Center for Environmental Health) - German Federal Ministry of Education and Research (BMBF)
European Union
German Federal Ministry of Education and Research
Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico; CNPq), Brazil
Evans Medical Foundation
Jay and Louis Coffman Endowment from the Department of Medicine, Boston University School of Medicine
Projekt DEAL
DOI 10.1186/s12933-021-01363-x
WOS ID WOS:000686702400002
Scopus ID 85112737090
PubMed ID 34407812
Erfassungsdatum 2021-09-21
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