A. Biderman et al., Sex differentials in predictors of mortality for patients with adult-onsetdiabetes - A population-based follow-up study in Beer-Sheva, Israel, DIABET CARE, 23(5), 2000, pp. 602-605
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 r
esiding in a well-defined geographical area and receiving primary health ca
re in 3 primary care community clinics were interviewed and examined betwee
n 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 hig
her triglyceride and uric acid levels was found for men who died compared w
ith men who survived, but this was not the case for women. Multivariate Poi
sson regression analysis showed significantly higher risk ratios for mortal
ity in men greater than or equal to 63 years of age, men with microalbumin
excretion greater than or equal to 30 mg/l, and men with higher triglycerid
e levels. In contrast, the analysis in women showed that higher GHb and cre
atinine levels and a reported history of heart disease were the only factor
s at the baseline examination significantly and independently associated wi
th an increased risk ratio of mortality.
CONCLUSIONS - The results suggest the existence of sex-specific interaction
s with various metabolic factors associated with diabetes that may have a d
ifferent effect on mortality for each sex.