Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals.

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  • Additional Information
    • Source:
      Publisher: Springer Verlag Country of Publication: Germany NLM ID: 0006777 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0428 (Electronic) Linking ISSN: 0012186X NLM ISO Abbreviation: Diabetologia Subsets: MEDLINE
    • Publication Information:
      Original Publication: Berlin Springer Verlag
    • Subject Terms:
      Diabetes Mellitus, Type 1/*epidemiology ; Diabetes Mellitus, Type 2/*epidemiology ; Heart Failure/*epidemiology; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 2/complications ; Female ; Heart Failure/etiology ; Humans ; Male ; Risk Factors ; Sex Factors
    • Abstract:
      Aims/hypothesis: The prevalence of diabetes and heart failure is increasing, and diabetes has been associated with an increased risk of heart failure. However, whether diabetes confers the same excess risk of heart failure in women and men is unknown. The aim of this study was to conduct a comprehensive systematic review with meta-analysis of possible sex differences in the excess risk of heart failure consequent to diabetes. Our null hypothesis was that there is no such sex difference.
      Methods: A systematic search was conducted in PubMed for population-based cohort studies published between January 1966 and November 2018. Studies were selected if they reported sex-specific estimates of RRs for heart failure associated with diabetes, and its associated variability, which were adjusted at least for age. Random-effects meta-analyses with inverse variance weighting were used to obtain pooled sex-specific RRs and women-to-men ratio of RRs (RRRs) for heart failure associated with diabetes.
      Results: Data from 47 cohorts, involving 12,142,998 individuals and 253,260 heart failure events, were included. The pooled multiple-adjusted RR for heart failure associated with type 1 diabetes was 5.15 (95% CI 3.43, 7.74) in women and 3.47 (2.57, 4.69) in men, leading to an RRR of 1.47 (1.44, 1.90). Corresponding pooled RRs for heart failure associated with type 2 diabetes were 1.95 (1.70, 2.22) in women and 1.74 (1.55, 1.95) in men, with a pooled RRR of 1.09 (1.05, 1.13).
      Conclusions/interpretation: The excess risk of heart failure associated with diabetes is significantly greater in women with diabetes than in men with diabetes. PROSPERO registration: CRD42019135246.
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    • Grant Information:
      MR/P014550/1 United Kingdom MRC_ Medical Research Council
    • Contributed Indexing:
      Keywords: Diabetes; Heart failure; Meta-analysis; Sex differences; Systematic review
    • Publication Date:
      Date Created: 20190719 Date Completed: 20200413 Latest Revision: 20240719
    • Publication Date:
      20240719
    • Accession Number:
      PMC6677875
    • Accession Number:
      10.1007/s00125-019-4926-x
    • Accession Number:
      31317230