Diabetes Care, Vol 23, Issue 5 602-605, Copyright © 2000 by American Diabetes Association
Sex differentials in predictors of mortality for patients with adult-onset diabetes: a population-based follow-up study in Beer-Sheva, Israel
A Biderman, I Rosenblatt, S Rosen, LM Zangwill, R Shalev, M Frigrer and S Weitzman
Department of Family Medicine, Faculty for Health Sciences and Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
OBJECTIVE: To test the hypothesis that factors predicting mortality differ
between diabetic men and women. RESEARCH DESIGN AND METHODS: A total of 498
known patients with diabetes residing in a well-defined geographical area
and receiving primary health care in 3 primary care community clinics were
interviewed and examined between 1988 and 1990. RESULTS: By 31 July 1998,
after a mean follow-up period of 7.8 years, 148 patients (68 men and 80
women) had died (29.7%). No statistical differences in survival rate or in
the specific causes of death were found between men and women. In the
univariate analysis of factors examined at baseline, GHb levels were
significantly higher among women who died compared with women who survived,
but this was not the case for men. Conversely, a trend of higher
triglyceride and uric acid levels was found for men who died compared with
men who survived, but this was not the case for women. Multivariate Poisson
regression analysis showed significantly higher risk ratios for mortality
in men > or = 63 years of age, men with microalbumin excretion > or =
30 mg/l, and men with higher triglyceride levels. In contrast, the analysis
in women showed that higher GHb and creatinine levels and a reported
history of heart disease were the only factors at the baseline examination
significantly and independently associated with an increased risk ratio of
mortality. CONCLUSIONS: The results suggest the existence of sex-specific
interactions with various metabolic factors associated with diabetes that
may have a different effect on mortality for each sex.