Abstract
Objectives The value of urinary albumin excretion in the prediction of myocardial ischemia in men and women with type 2 diabetes is less understood. We questioned if gender influence albuminuria-ischemic heart disease relationship, in patients with type 2 diabetes.
Methods We designed a matched case control study on 926 patients with albuminuria defined as cases, and 926 age, BMI matched patients without albuminuria, defined as controls. Ischemic heart disease was defined as the presence of 1: history of angina pectoris or angina equivalent symptoms and CCU admission, 2: myocardial infarction and/or electrocardiographic evidence of Q-wave myocardial infarction 3: coronary revascularization and/or stenting 4: positive myocardial spect scan 5: ischemic ST-segment or T-wave changes and 6: positive stress testing.
Results Patients with albuminuria had a lower GFR and a longer diabetes-duration than patients without albuminuria. In the group of patients with albuminuria, there were a greater number of men with ischemic heart disease compared to women (120/370 (32.4%) vs. 97/559 (17.4%); P <0.001). The odds ratio of having ischemic heart disease according to the presence or absence of albuminuria were (1.25 [1.01–1.56]; (P <0.05) in all studied population, (0.79 [0.51–1.21] (P =0.14)) in women and (2.84 [1.68–4.79]) (P <0.001)) in men. We showed while diabetes-duration, HDL, LDL and HbA1c influence albuminuria in women, diabetes-duration, FBS and diastolic blood pressure influence albuminuria in men
Conclusions Men with albuminuria are at an increased risk of ischemic heart disease compared to women. This may be related to the role of HDL on albuminuria-gender relationship.
- Received May 10, 2011.
- Revision received October 12, 2011.
- Revision received September 8, 2011.
- Accepted September 21, 2011.
