The impact of sex on risk of cardiovascular disease and all-cause mortality in adults with or without diabetes mellitus: A comparison between the U.S. and Japan

Longjian Liu, Katsuyuki Miura, Aya Kadota, Akira Fujiyoshi, Edward J. Gracely, Fuzhong Xue, Zuolu Liu, Naoyuki Takashima, Naoko Miyagawa, Takayoshi Ohkubo, Hisatomi Arima, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Aims: To test a hypothesis that women with diabetes mellitus (DM)versus those without DM had a significantly higher risk of heart disease (HD), stroke and all-cause mortality than their male counterparts in the U.S. as well as in Japan. Methods: We analyzed two nationally representative datasets, one from the U.S. NHANES III cohort (n = 13,169), and the other from the Japan NIPPON DATA90 cohort (n = 7445). Hazard ratios (HRs)of DM for risk of mortality and sex-DM interaction effect on mortality were analyzed prospectively using Cox's proportional hazards regression models. Results: Patients with DM had significantly higher mortality from HD, stroke and all-cause mortality in the U.S. and in Japan. However, the HRs of DM versus non-DM for HD and all-cause mortality were significantly higher in women compared to men in the U.S. (sex-DM interaction: HR = 1.59, p = 0.01, and 1.24, p = 0.045 for HD and all-cause mortality), but the sex-DM interaction effect was not statistically significant in the Japanese cohort. Discussion: Patients with DM had a significantly higher risk of mortality than those without DM in the U.S. and Japan. However, women with DM versus those without DM had a higher relative risk of HD and all-cause mortality than their counterparts in men in the U.S, but this sex difference by DM status was not observed in the Japanese cohort. Whether the sex-difference effect of DM on HD and all-cause mortality is due to a difference in metabolic disorders between the two populations warrants consideration and further studies.

Original languageEnglish
Pages (from-to)417-423
Number of pages7
JournalJournal of Diabetes and its Complications
Volume33
Issue number6
DOIs
Publication statusPublished - 2019 Jun

Keywords

  • CVD
  • Diabetes mellitus
  • US-Japan comparison

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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    Liu, L., Miura, K., Kadota, A., Fujiyoshi, A., Gracely, E. J., Xue, F., Liu, Z., Takashima, N., Miyagawa, N., Ohkubo, T., Arima, H., Okayama, A., Okamura, T., & Ueshima, H. (2019). The impact of sex on risk of cardiovascular disease and all-cause mortality in adults with or without diabetes mellitus: A comparison between the U.S. and Japan. Journal of Diabetes and its Complications, 33(6), 417-423. https://doi.org/10.1016/j.jdiacomp.2019.03.008