Dataset Information

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

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).

SUBMITTER: Rentsch CT

PROVIDER: S-EPMC10477037 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Rentsch Christopher T CT Garfield Victoria V Mathur Rohini R Eastwood Sophie V SV Smeeth Liam L Chaturvedi Nish N Bhaskaran Krishnan K

The Lancet regional health. Europe 20230810

<h4>Background</h4>We sought to examine sex-specific risks for incident cardiovascular disease (CVD) across the full glycaemic spectrum.<h4>Methods</h4>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), pulmon ...[more]

PMID: 37671124

Similar Datasets

Project description:IntroductionIn addition to the well-recognised cardiotoxicity of cancer treatment, possible aetiological links between cancer diagnosis and cardiovascular disease (CVD) have gained growing research interests. We aimed to estimate the CVD burden among cancer survivors and illustrate population-level associations between these two conditions.MethodsWe first conducted a prospective cohort study in the UK Biobank and a meta-analysis of previous population-based cohorts. HRs were estimated in the cohort study to evaluate the effect of cancer diagnosis on the subsequent risk of CVD compared with that of non-cancer individuals. We then systematically searched Pubmed, Embase and Cochrane Library to retrieve previous cohorts. Random-effect meta-analysis was performed to pool relative risk estimates. A combination of multiple statistical metrics was employed to appraise the evidence.ResultsA total of 39 755 811 participants (5 898 597 cancer survivors vs 33 857 214 cancer-free controls) were identified in our study. In the cohort study, a 51% higher hazard of CVD risk was found among cancer survivors (95% CI 1.48 to 1.55, p<0.001). The hazard decreased to 29% after adjusting competing risk. The meta-analysis identified 104 published cohorts. We found a 1.34-fold increased CVD risk among patients with cancer (95% CI 1.22 to 1.47, p<0.001). The association remains significant among multiple cancer sites and multiple CVD subtypes. This association was consistent, irrespective of chemo or radiotherapy use. Evidence appraisal identified one convincing association between hematologic/lymphatic malignancies and ischaemic heart disease, along with 29 highly suggestive associations.ConclusionsOur study provided comprehensive estimates of CVD incidence in cancer survivors and identified a significantly elevated CVD risk among patients with cancer, regardless of chemotherapy or radiotherapy. These findings underscore the need for routine assessment of CVD risk factors at cancer diagnosis to enhance the well-being and survival of patients with cancer.PROSPERO registration numberCRD42022307056.

Dataset Information

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

Background

Methods

Findings

Interpretation

Funding

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets