Abstract P224: Sex Differences in the Risk of Stroke and HbA1c among Diabetic Patients
Background: Epidemiological studies have reported that type 2 diabetes is an independent risk factor for stroke, but how much its effect varies by sex is uncertain.
Aim: To better understand the relationship between glycemic control and stroke risk in men and women, we studied a large sample of patients with type 2 diabetes with long-term follow up.
Methods: We prospectively investigated the sex-specific association of different levels of HbA1c with incident stroke risk among 10,876 male and 19,278 female diabetic patients within the Louisiana State University (LSU) Hospital System.
Results: During a mean follow up of 6.7 years, 2,949 incident cases of stroke were identified. The multivariable-adjusted hazard ratios (HRs) of stroke associated with different levels of HbA1c at baseline (<6.0%, 6.0-6.9% [reference group], 7.0-7.9%, 8.0-8.9%, 9.0-9.9%, and ≥10.0%,) were 0.96 (95% confidence interval [CI] 0.80-1.14), 1.00, 1.04 (0.85-1.28), 1.11 (0.89-1.39), 1.10 (0.86-1.41), and 1.22 (0.92-1.35) (P trend =0.66) for males, and 1.03 (0.90-1.18), 1.00, 1.09 (0.94-1.26), 1.19 (1.00-1.42), 1.32 (1.09-1.59), and 1.42 (1.23-1.65) (P trend <0.001) for females, respectively. The graded association of HbA1c during follow-up with stroke risk was observed among female diabetic patients (P trend=0.066). When stratified by race, with glucose-lowering agents or not, this graded association of HbA1c with stroke was still present. When stratified by age, the adjusted HRs were significantly higher in women older than 55 years compared to younger women.
Conclusions: The current study suggests a graded association between HbA1c and the risk of stroke among female patients with type 2 diabetes and poor control of blood sugar has a stronger effect in women older than 55 years.
Author Disclosures: G. Hu: None. P. Katzmarzyk: None. R. Horswell: None. Y. Wang: None. J. Johnson: None. W. Zhao: None.
- © 2014 by American Heart Association, Inc.