Abstract P144: Diabetes as a Risk Factor for Stroke in Women Compared with Men
Introduction: Diabetes mellitus is a major cause of death and disability worldwide and is a strong risk factor for stroke. It is currently unknown if, and to what extent, the excess risk of stroke conferred by diabetes differs between the sexes. We performed a systematic review and meta-analysis to estimate the relative effect of diabetes on stroke risk in women compared with men.
Methods: PubMed MEDLINE was systematically searched for prospective population-based cohort studies published between on January 1, 1966 and February 13, 2013. Studies were selected if they reported sex-specific estimates of the relative risk (RR) for stroke associated with diabetes, and its associated variability. The sex-specific RRs and their ratio, comparing women with men, were pooled using random effects meta-analysis with inverse variance weighting.
Results: Data from 58 cohort studies representing 773,379 individuals and 12,253 fatal and non-fatal strokes were included in this analysis. The pooled maximal-adjusted RR of stroke associated with diabetes was 2.29 (95% confidence interval [CI]:1.93, 2.72) in women and 1.85 (1.61, 2.12) in men. Compared with men, women with diabetes thus had a greater risk of stroke: pooled ratio RR 1.26 (1.09, 1.46), I2=0%, with no evidence of publication bias. This finding was statistically robust and observed within all of the pre-specified subgroups and did not differ materially within any of the sensitivity analyses that were undertaken.
Conclusions: The excess risk of stroke associated with diabetes is significantly higher in women than men, independent of sex differences in levels of other major cardiovascular risk factors. These data further strengthen the observation that men and women experience diabetes-related diseases differently and heighten the need for further work to clarify the biological, behavioral or social mechanisms that are involved.
Author Disclosures: S.A.E. Peters: None. R.R. Huxley: None. M. Woodward: None.
- © 2014 by American Heart Association, Inc.