UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Sex-specific risks for cardiovascular disease across the glycaemic spectrum: a population-based cohort study using the UK Biobank

Rentsch, CT; Garfield, V; Mathur, R; Eastwood, SV; Smeeth, L; Chaturvedi, N; Bhaskaran, K; (2023) Sex-specific risks for cardiovascular disease across the glycaemic spectrum: a population-based cohort study using the UK Biobank. The Lancet Regional Health - Europe , 32 , Article 100693. 10.1016/j.lanepe.2023.100693. Green open access

[thumbnail of 1-s2.0-S2666776223001126-main.pdf]
Preview
Text
1-s2.0-S2666776223001126-main.pdf - Published Version

Download (1MB) | Preview

Abstract

BACKGROUND: We sought to examine sex-specific risks for incident cardiovascular disease (CVD) across the full glycaemic spectrum. METHODS: Using data from UK Biobank, we categorised participants’ glycated haemoglobin (HbA1c) at baseline as low-normal (<35 mmol/mol), normal (35–41 mmol/mol), pre-diabetes (42–47 mmol/mol), undiagnosed diabetes (≥48 mmol/mol), or diagnosed diabetes. Our outcomes were coronary artery disease (CAD), atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, heart failure, and a composite outcome of any CVD. Cox regression estimated sex-specific associations between HbA1c and each outcome, sequentially adjusting for socio-demographic, lifestyle, and clinical characteristics. FINDINGS: Among 427,435 people, CVD rates were 16.9 and 9.1 events/1000 person-years for men and women, respectively. Both men and women with pre-diabetes, undiagnosed diabetes, and, more markedly, diagnosed diabetes were at higher risks of CVD than those with normal HbA1c, with relative increases more pronounced in women than men. Age-adjusted HRs for pre-diabetes and undiagnosed diabetes ranged from 1.30 to 1.47; HRs for diagnosed diabetes were 1.55 (1.49–1.61) in men and 2.00 (1.89–2.12) in women (p-interaction <0.0001). Excess risks attenuated and were more similar between men and women after adjusting for clinical and lifestyle factors particularly obesity and antihypertensive or statin use (fully adjusted HRs for diagnosed diabetes: 1.06 [1.02–1.11] and 1.17 [1.10–1.24], respectively). INTERPRETATION: Excess risks in men and women were largely explained by modifiable factors, and could be ameliorated by attention to weight reduction strategies and greater use of antihypertensive and statin medications. Addressing these risk factors could reduce sex disparities in risk of CVD among people with and without diabetes. FUNDING: Diabetes UK (#15/0005250) and British Heart Foundation (SP/16/6/32726).

Type: Article
Title: Sex-specific risks for cardiovascular disease across the glycaemic spectrum: a population-based cohort study using the UK Biobank
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.lanepe.2023.100693
Publisher version: https://doi.org/10.1016/j.lanepe.2023.100693
Language: English
Additional information: © 2023 The Author(s). Published by Elsevier Ltd. under a Creative Commons license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Cardiovascular disease, Cohort analysis, HbA1c, Hyperglycaemia, Population studies
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10177000
Downloads since deposit
17Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item