Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study

Tracy E. Madsen, Jane C. Khoury, Kathleen A. Alwell, Charles J. Moomaw, Stacie L. Demel, Matthew L. Flaherty, Daniel Woo, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Simona Ferioli, Opeolu Adeoye, Pooja Khatri, Brett M. Kissela, Dawn Kleindorfer

Research output: Contribution to journalArticle

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Abstract

Background: The aim of the present study was to compare sex-specific associations between cardiovascular risk factors and diabetes mellitus (DM) among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS). Methods: The GCNKSS ascertained AIS cases in 2005 and 2010 among adult (age ≥ 20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors were compared between those with and without DM using Chi-squared tests and multiple logistic regression analysis to examine sex-specific profiles. Results: There were 3515 patients with incident AIS; 1919 (55%) were female, 697 (20%) were Black, and 1146 (33%) had DM. Among both women and men with DM, significantly more were obese and had hypertension, high cholesterol, and coronary artery disease (CAD) compared with those without DM. For women with AIS, multivariable sex-specific adjusted analyses revealed that older age was associated with decreased odds of having DM (adjusted odds ratio [aOR] 0.88, 95% confidence interval [CI] 0.80–0.98). For women with CAD, the odds of DM were increased (aOR 1.76, 95% CI 1.33–2.32). Age and CAD were not significant factors in differentiating the profiles of men with and without DM. Conclusions: Women with DM had strokes at a younger age, whereas no such age difference existed in men. Compared with men, women with DM were also more likely to have CAD than those without DM, suggesting a sex difference in the association between DM and vascular disease. These findings may suggest a need for more aggressive risk factor management in diabetic women.

Original languageEnglish (US)
Pages (from-to)496-501
Number of pages6
JournalJournal of Diabetes
Volume10
Issue number6
DOIs
StatePublished - Jun 1 2018

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Sex Characteristics
Diabetes Mellitus
Stroke
Coronary Artery Disease
Odds Ratio
Confidence Intervals
Risk Management
Vascular Diseases
Logistic Models
Cholesterol
Regression Analysis
Hypertension

Keywords

  • diabetes
  • risk factors
  • sex differences
  • stroke

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Madsen, T. E., Khoury, J. C., Alwell, K. A., Moomaw, C. J., Demel, S. L., Flaherty, M. L., ... Kleindorfer, D. (2018). Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study. Journal of Diabetes, 10(6), 496-501. https://doi.org/10.1111/1753-0407.12567

Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study. / Madsen, Tracy E.; Khoury, Jane C.; Alwell, Kathleen A.; Moomaw, Charles J.; Demel, Stacie L.; Flaherty, Matthew L.; Woo, Daniel; Mackey, Jason; De Los Rios La Rosa, Felipe; Martini, Sharyl; Ferioli, Simona; Adeoye, Opeolu; Khatri, Pooja; Kissela, Brett M.; Kleindorfer, Dawn.

In: Journal of Diabetes, Vol. 10, No. 6, 01.06.2018, p. 496-501.

Research output: Contribution to journalArticle

Madsen, TE, Khoury, JC, Alwell, KA, Moomaw, CJ, Demel, SL, Flaherty, ML, Woo, D, Mackey, J, De Los Rios La Rosa, F, Martini, S, Ferioli, S, Adeoye, O, Khatri, P, Kissela, BM & Kleindorfer, D 2018, 'Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study', Journal of Diabetes, vol. 10, no. 6, pp. 496-501. https://doi.org/10.1111/1753-0407.12567
Madsen, Tracy E. ; Khoury, Jane C. ; Alwell, Kathleen A. ; Moomaw, Charles J. ; Demel, Stacie L. ; Flaherty, Matthew L. ; Woo, Daniel ; Mackey, Jason ; De Los Rios La Rosa, Felipe ; Martini, Sharyl ; Ferioli, Simona ; Adeoye, Opeolu ; Khatri, Pooja ; Kissela, Brett M. ; Kleindorfer, Dawn. / Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study. In: Journal of Diabetes. 2018 ; Vol. 10, No. 6. pp. 496-501.
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abstract = "Background: The aim of the present study was to compare sex-specific associations between cardiovascular risk factors and diabetes mellitus (DM) among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS). Methods: The GCNKSS ascertained AIS cases in 2005 and 2010 among adult (age ≥ 20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors were compared between those with and without DM using Chi-squared tests and multiple logistic regression analysis to examine sex-specific profiles. Results: There were 3515 patients with incident AIS; 1919 (55{\%}) were female, 697 (20{\%}) were Black, and 1146 (33{\%}) had DM. Among both women and men with DM, significantly more were obese and had hypertension, high cholesterol, and coronary artery disease (CAD) compared with those without DM. For women with AIS, multivariable sex-specific adjusted analyses revealed that older age was associated with decreased odds of having DM (adjusted odds ratio [aOR] 0.88, 95{\%} confidence interval [CI] 0.80–0.98). For women with CAD, the odds of DM were increased (aOR 1.76, 95{\%} CI 1.33–2.32). Age and CAD were not significant factors in differentiating the profiles of men with and without DM. Conclusions: Women with DM had strokes at a younger age, whereas no such age difference existed in men. Compared with men, women with DM were also more likely to have CAD than those without DM, suggesting a sex difference in the association between DM and vascular disease. These findings may suggest a need for more aggressive risk factor management in diabetic women.",
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AU - Demel, Stacie L.

AU - Flaherty, Matthew L.

AU - Woo, Daniel

AU - Mackey, Jason

AU - De Los Rios La Rosa, Felipe

AU - Martini, Sharyl

AU - Ferioli, Simona

AU - Adeoye, Opeolu

AU - Khatri, Pooja

AU - Kissela, Brett M.

AU - Kleindorfer, Dawn

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N2 - Background: The aim of the present study was to compare sex-specific associations between cardiovascular risk factors and diabetes mellitus (DM) among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS). Methods: The GCNKSS ascertained AIS cases in 2005 and 2010 among adult (age ≥ 20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors were compared between those with and without DM using Chi-squared tests and multiple logistic regression analysis to examine sex-specific profiles. Results: There were 3515 patients with incident AIS; 1919 (55%) were female, 697 (20%) were Black, and 1146 (33%) had DM. Among both women and men with DM, significantly more were obese and had hypertension, high cholesterol, and coronary artery disease (CAD) compared with those without DM. For women with AIS, multivariable sex-specific adjusted analyses revealed that older age was associated with decreased odds of having DM (adjusted odds ratio [aOR] 0.88, 95% confidence interval [CI] 0.80–0.98). For women with CAD, the odds of DM were increased (aOR 1.76, 95% CI 1.33–2.32). Age and CAD were not significant factors in differentiating the profiles of men with and without DM. Conclusions: Women with DM had strokes at a younger age, whereas no such age difference existed in men. Compared with men, women with DM were also more likely to have CAD than those without DM, suggesting a sex difference in the association between DM and vascular disease. These findings may suggest a need for more aggressive risk factor management in diabetic women.

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