scholarly journals Association between diabetes mellitus and the risk for major cardiovascular outcomes and all-cause mortality in women compared with men: a meta-analysis of prospective cohort studies

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e024935
Author(s):  
Hao Wang ◽  
Ying Ba ◽  
Run-Ce Cai ◽  
Qian Xing

ObjectivePrevious studies have reported sex differences in associations between diabetes mellitus (DM) and the risk of developing coronary heart disease (CHD) and stroke; however, the risk for cardiac death and all-cause mortality in women compared with men has not been reported. Therefore, this quantitative meta-analysis was performed to provide reliable estimates of sex differences in the effect of DM on major cardiovascular outcomes and all-cause mortality, irrespective of DM type.DesignMeta-analysis.Data sourcesThe PubMed, Embase and the Cochrane Library databases were systematically searched in April 2018.Eligibility criteriaInvestigations designed as prospective cohort studies that examined the association between DM and major cardiovascular outcomes and all-cause mortality stratified according to sex were included.Data extraction and synthesisData extraction and quality assessment were independently performed by 2 of the authors, and the relative risk ratio (RRR) obtained using a random effects model was used to measure sex differences in the associations of DM with major cardiovascular outcomes and all-cause mortality.ResultsThirty prospective cohort studies that reported data from 1 148 188 individuals were included. The pooled women-to-men RRR suggested that female sex was associated with an increased risk for CHD (RRR 1.52(95% CI 1.32 to 1.76); p<0.001), stroke (RRR 1.23(95% CI 1.09 to 1.39); p=0.001), cardiac death (RRR 1.49(95% CI 1.11 to 2.00); p=0.009) and all-cause mortality (RRR 1.51(95% CI 1.23 to 1.85); p<0.001). In addition, sex differences for the investigated outcomes in the comparison between DM and non-DM patients were variable after stratification of studies according to publication year, country, sample size, assessment of DM, follow-up duration, adjustment for important cardiovascular risk factors and study quality.ConclusionsFindings of the present study suggested that women with DM had an extremely high risk for CHD, stroke, cardiac death and all-cause mortality compared with men with DM.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiangmei Zhao ◽  
Dongying Wang ◽  
Lijie Qin

Abstract Background This meta-analysis based on prospective cohort studies aimed to evaluate the associations of lipid profiles with the risk of major adverse cardiovascular outcomes in patients with coronary heart disease (CHD). Methods The PubMed, Embase, and Cochrane Library electronic databases were systematically searched for prospective cohort study published through December 2019, and the pooled results were calculated using the random-effects model. Results Twenty-one studies with a total of 76,221 patients with CHD met the inclusion criteria. The per standard deviation (SD) increase in triglyceride was associated with a reduced risk of major adverse cardiovascular events (MACE). Furthermore, the per SD increase in high-density lipoprotein cholesterol (HDL-C) was associated with a reduced risk of cardiac death, whereas patients with lower HDL-C were associated with an increased risk of MACE, all-cause mortality, and cardiac death. Finally, the risk of MACE was significantly increased in patients with CHD with high lipoprotein(a) levels. Conclusions The results of this study suggested that lipid profile variables could predict major cardiovascular outcomes and all-cause mortality in patients with CHD.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Peter T Katzmarzyk ◽  
I-Min Lee

Introduction: Sedentary behaviors such as television viewing are ubiquitous in modern society. Several prospective studies have demonstrated an association between television viewing and incident obesity and type 2 diabetes as well as cardiovascular disease and all-cause mortality. Hypothesis: We tested the null hypothesis that television viewing has no impact on life expectancy in the United States. Methods: A prevalence-based cause-deleted methodology was used to estimate the gains in life expectancy in the population that would be expected under current mortality patterns if television viewing was eliminated as a potential risk factor in the United States. The population attributable fraction (PAF, calculated using adjusted relative risk (RR) = ∑P(RR-1/RR)) was computed from the RR of all-cause mortality associated with television viewing (2–3.9 h and ≥4 h versus < 2 h) obtained from a meta-analysis of available prospective cohort studies, and the estimated case prevalence (P) of television viewing obtained from the U.S. National Health and Nutrition Examination Survey (2005–06) and the prospective cohort studies. The resulting PAF was applied to mortality rates among 18+ year olds living in the United States and an abridged life table analysis was used to estimate the potential gains in life expectancy. Results: Three prospective cohort studies contributed data to the meta-analysis, yielding summary RR estimates for all-cause mortality of 1.17 (95% CI: 1.04 – 1.32) and 1.49 (95% CI: 1.22–1.82) for 2–3.9 h and ≥4 h of television viewing versus <2 h, respectively. The estimated case prevalences of television viewing in the U.S. population were 23.8%, 45.7% and 37.2% for <2 h, 2–3.9 h and ≥4 h of television viewing, respectively. The estimated gain in life expectancy in the US population associated with television viewing was 1.38 years. The lower and upper limits from a sensitivity analysis which involved simultaneously varying the estimates of RR (using the upper and lower bounds of the 95% CI) and the prevalence of television viewing (± 20%) were 0.48 years and 2.50 years. Conclusions: Reducing sedentary behaviors such as television viewing has the potential to increase life expectancy in the United States.


2015 ◽  
Vol 16 (11) ◽  
pp. 1381-1387 ◽  
Author(s):  
Xiaoti Lin ◽  
Weiyu Chen ◽  
Fengqin Wei ◽  
Mingang Ying ◽  
Weidong Wei ◽  
...  

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