Compared to individuals without type 2 diabetes mellitus, the relative increase in cardiovascular mortality is much higher in women than in men in individuals with type 2 diabetes mellitus. We evaluated data from 7443 individuals (3792 women, 50.9%), aged 20 to 81 years, from two independent population-based investigations, SHIP-0 and MONICA/KORA S3. We analyzed the longitudinal sex-specific associations of lipoprotein(a) with cardiovascular mortality in individuals with and without type 2 diabetes mellitus using Cox regression. During a median follow-up of 20.5 years (136,802 person-years), 657 participants (404 men and 253 women) died of cardiovascular causes. Among individuals without type 2 diabetes mellitus, men had a significantly higher risk for cardiovascular mortality compared to women in unadjusted model and after adjustment. On the other hand, in participants with type 2 diabetes mellitus, the risk for cardiovascular mortality was not different between men and women in the unadjusted model and after adjustment for age, body mass index, low-density lipoprotein-cholesterol, fasting status and study sample (SHIP-0, MONICA/KORA S3). Further adjustment for lipoprotein(a) concentrations had no impact on the hazard ratio (HR) for cardiovascular mortality comparing men versus women in individuals without type 2 diabetes mellitus [HR: 1.94; 95% confidence interval (CI) 1.63 to 2.32; p < 0.001]. In individuals with type 2 diabetes mellitus, however, further adjustment for lipoprotein(a) led to an increased risk for cardiovascular mortality in men and a decreased risk in women resulting in a statistically significant difference between men and women (HR: 1.53; 95% CI 1.04 to 2.24; p = 0.029). Women are described to have a stronger relative increase in cardiovascular mortality than men when comparing individuals with and without type 2 diabetes mellitus. Higher lipoprotein(a) concentrations in women with type 2 diabetes mellitus than in men with type 2 diabetes mellitus might partially explain this finding.

中文翻译：

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脂蛋白（a）浓度的性别特异性差异与 2 型糖尿病患者心血管死亡率的相关性

与没有 2 型糖尿病的个体相比，在患有 2 型糖尿病的个体中，女性心血管死亡率的相对增加远高于男性。我们评估了 7443 名年龄在 20 至 81 岁之间的个体（3792 名女性，50.9%）的数据，这些数据来自两个独立的基于人群的调查，SHIP-0 和 MONICA/KORA S3。我们使用 Cox 回归分析了脂蛋白 (a) 与 2 型糖尿病患者和非 2 型糖尿病患者心血管死亡率的纵向性别特异性关联。在中位随访 20.5 年（136,802 人年）期间，657 名参与者（404 名男性和 253 名女性）死于心血管疾病。在没有 2 型糖尿病的个体中，与未调整模型和调整后的女性相比，男性的心血管死亡风险显着更高。另一方面，在 2 型糖尿病参与者中，在未调整模型中以及在调整年龄、体重指数、低密度脂蛋白胆固醇、禁食状态和研究后，男性和女性的心血管死亡风险没有差异。样品（SHIP-0，MONICA/KORA S3）。进一步调整脂蛋白 (a) 浓度对非 2 型糖尿病患者的男性与女性心血管死亡率的风险比 (HR) 没有影响 [HR: 1.94; 95% 置信区间 (CI) 1.63 至 2.32；p < 0.001]。然而，在 2 型糖尿病患者中，进一步调整脂蛋白 (a) 导致男性心血管死亡风险增加，女性风险降低，导致男性和女性之间存在统计学显着差异（HR：1.53；95% CI 1。04 至 2.24；p = 0.029）。在比较患有和不患有 2 型糖尿病的个体时，女性被描述为心血管死亡率的相对增加比男性强。与 2 型糖尿病男性相比，2 型糖尿病女性的脂蛋白 (a) 浓度可能部分解释了这一发现。