TY - JOUR
T1 - The Metabolic Syndrome and the Impact of Diabetes on Coronary Heart Disease Mortality in Women and Men
T2 - The San Antonio Heart Study
AU - Hunt, Kelly J.
AU - Williams, Ken
AU - Hazuda, Helen P.
AU - Stern, Michael P.
AU - Haffner, Steve M.
N1 - Funding Information:
Grants from the National Heart, Lung and Blood Institute (R01-HL24799 and R01-HL36820), National Institute of Diabetes and Digestive and Kidney Diseases (K01 Award, 1K01 DK064867), and the American Diabetes Association (Research Award, 7-03-RA-118) supported this work.
PY - 2007/11
Y1 - 2007/11
N2 - Purpose: An explanation for the differential impact of diabetes on coronary heart disease (CHD) mortality in men and women is that diabetes and cardiovascular disease (CVD) share a common antecedent that differentially affects men and women. In the San Antonio Heart Study we examined the relationship between gender, the metabolic syndrome defined by the National Cholesterol Education Program (NCEP-MetS) and diabetes and their ability to predict CHD mortality. Methods: Over 15.5 years, 4996 men and women 25 to 64 years of age experienced 254 cardiovascular deaths, including 121 from CHD (International Classification of Diseases, Ninth Revision codes 410-414). Results: At baseline, NCEP-MetS occurred more often in men than in women among those with normal glucose levels (12.3% vs. 9.7%, p < 0.05), but less often in men than in women among those with diabetes (65.7% vs. 74.4%, p < 0.05). Adjusted for age, ethnic group, and a history of CVD, relative to women with neither diabetes nor NCEP-MetS, women with both had a 14-fold (hazard ratio [HR] = 14.3 [95% confidence interval: 6.62, 30.7]) increased risk of CHD mortality, whereas men had only a 4-fold (HR = 4.21 (95% confidence interval: 2.32, 7.65]) increased risk, respectively. Conclusion: When diabetes occurred with NCEP-MetS, gender was a strong modifier of the joint effect of diabetes and NCEP-MetS on CHD mortality.
AB - Purpose: An explanation for the differential impact of diabetes on coronary heart disease (CHD) mortality in men and women is that diabetes and cardiovascular disease (CVD) share a common antecedent that differentially affects men and women. In the San Antonio Heart Study we examined the relationship between gender, the metabolic syndrome defined by the National Cholesterol Education Program (NCEP-MetS) and diabetes and their ability to predict CHD mortality. Methods: Over 15.5 years, 4996 men and women 25 to 64 years of age experienced 254 cardiovascular deaths, including 121 from CHD (International Classification of Diseases, Ninth Revision codes 410-414). Results: At baseline, NCEP-MetS occurred more often in men than in women among those with normal glucose levels (12.3% vs. 9.7%, p < 0.05), but less often in men than in women among those with diabetes (65.7% vs. 74.4%, p < 0.05). Adjusted for age, ethnic group, and a history of CVD, relative to women with neither diabetes nor NCEP-MetS, women with both had a 14-fold (hazard ratio [HR] = 14.3 [95% confidence interval: 6.62, 30.7]) increased risk of CHD mortality, whereas men had only a 4-fold (HR = 4.21 (95% confidence interval: 2.32, 7.65]) increased risk, respectively. Conclusion: When diabetes occurred with NCEP-MetS, gender was a strong modifier of the joint effect of diabetes and NCEP-MetS on CHD mortality.
KW - Coronary Disease
KW - Diabetes Mellitus, Type 2
KW - Epidemiology
KW - Gender
KW - Metabolic Syndrome X
KW - Mortality
KW - Risk Factors
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U2 - 10.1016/j.annepidem.2007.05.012
DO - 10.1016/j.annepidem.2007.05.012
M3 - Article
C2 - 17662617
AN - SCOPUS:35348919453
SN - 1047-2797
VL - 17
SP - 870
EP - 877
JO - Annals of epidemiology
JF - Annals of epidemiology
IS - 11
ER -