medigraphic.com

2020, Number 2

<< Back Next >>

Rev Cuba Endoc 2020; 31 (2)

Risk factors associated with cardiovascular complications in middle-aged women with type 2 diabetes mellitus

Valdés RER, Valdés BER, Valdés BNN

Language: Spanish
References: 34
Page: 1-14
PDF size: 384.22 Kb.


ABSTRACT

Introduction: In middle-aged diabetic women, a series of atherogenic factors converge that favor the appearance of cardiovascular complications.
Objective: To identify the risk factors associated with cardiovascular complications in middle-aged women with type 2 diabetes mellitus.
Methods: An analytical case-control study was carried out with middle-aged (40-49 years old) women with type 2 diabetes and who were admitted to the Diabetic Care Center in Bayamo City, Granma, from 2010 to 2017. Women with artificial menopause were not part of the study. The sample was made up of 375 patients, who were selected by simple randomized sampling: 125 presented cardiovascular complications (cases) and 250 presented no complications (controls).
Results: The number of women with cardiovascular complications was correspondingly higher with menopause and with the time after the occurrence of this event (p = 0.0125). Univariate analysis showed that seven factors increased the risk for presenting cardiovascular complications, among them menopause (OR = 1.88, CI: 1.1-3.0, p = 0.0077); while multivariate analysis showed that only three of them did so independently, which were time of evolution of diabetes over ten years (OR = 4.97, CI: 2.35-10.54, p = 0.000), arterial hypertension (OR = 3.58, CI: 1.71-7.48, p = 0.001), and smoking (OR=2.605, CI: 1.47-4.59, p = 0.001).
Conclusions: The main risk factors associated with cardiovascular complications among middle-aged women with type 2 diabetes mellitus were time of evolution of diabetes over ten years, arterial hypertension, and smoking.


REFERENCES

  1. Defronzo RA. Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009;58(4):773-795.

  2. American Diabetes Association. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S86-S104.

  3. Rawshani A, Rawshani A, Franzén S, Eliasson B, Svensson AM, Miftaraj M, et al. Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med. 2017;376:1407-18.

  4. El Khoudary SR, Shields KJ, Janssen I, Hanley C, Budoff MJ, Barinas-Mitchell E, et al. Cardiovascular fat, menopause, andsex hormones in women: the SWAN cardiovascular fat ancillarystudy. J Clin Endocrinol Metab. 2015;100:3304-12.

  5. Grundy SM. Guidelines for cholesterol management: recommendations of the National Cholesterol Education Program's Adult Treatment Panel II. Heart Dis Stroke 1994;3(3):123-7.

  6. Gerstein HC. Diabetes: Dysglycaemia as a cause of cardiovascular outcomes. Nat Rev Endocrinol. Sep 2015;11(9):508-10; DOI:10.1038/nrendo.2015.

  7. Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract. 2017;23(4):479-97. JellingerPSHandelsmanYRosenblitPDBloomgardenZTFonsecaVAGarberAJet alAmerican Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for management of dyslipidemia and prevention of cardiovascular diseaseEndocr Pract2017234479-97

  8. American Diabetes Association. Clasificación y diagnóstico de la diabetes: Estándares para la Atención Médica de la Diabetes -2019. Diabetes Care. 2019;42(Suppl.1):S13-S28.

  9. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 5 Feb 2014;311(5):507-20.

  10. World Health Organization (WHO). Expert Committee Phycal Status. The use and interpretation of anthropometry. Geneva: Technical Report; 1995. (Series No. 854).

  11. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP), Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97.

  12. Alloin CC, Poon LSY, Chan CSG. Enzimatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470-5.

  13. Bucolo. G, David H. Quantitative determination of serum triglicerides by use of enzimes. Clin Chem. 1973;19(5):475-82.

  14. Primer consenso cubano de dislipoproteinemias: Guía para la prevención, detección, diagnóstico y tratamiento. Rev Cubana Endocrinol. 2006;17(4):1-31.

  15. Trinder P. Determination of glucose in blood using glucose oxidase with on alternative oxigen acceptor. Clin Biochem. 1996;11(2)24-7.

  16. Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman R, Bailey T, et al. American Association of Clinical Endocrinologists and American College of Endocrinology -clinical practice guidelines for developing a diabetes mellitus comprehensive care plan- 2015. Endocr Pract. 2015;21 (Suppl 1):S1-S87

  17. Sarduy M, Lugones M. II Consenso Cubano de Climaterio y Menopausia. Capítulo 1. La Habana: CIMEQ; 2007. p. 15.

  18. Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001;286(11):1317-24.

  19. Gerstein HC. Diabetes: Dysglycaemia as a cause of cardiovascular outcomes. Nat Rev Endocrinol. 2015;11(9):508-10.

  20. American Diabetes Association. 10. Enfermedad cardiovascular y manejo del riesgo: Estándares para la Atención Médica de la Diabetes-2019. Diabetes Care, edición en español 2019;42(Suppl. 1):S100-S119

  21. Bertoluci MC, Rocha VZ. Cardiovascular risk assessment in patients with diabetes. Diabetol Metab Syndr. 2017;9:25. DOI: 10.1186/s13098-017-0225-1

  22. Fernández MJ, Basurto L, Córdova N, Vázquez AL, Tepach N, Vega S, et al. Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women. Rev Esp Cardiol. 2014;67(6): 436-41.

  23. Miguel PE. Predictores de riesgo cardiometabólico. Rev Finlay. 2015;5(2):80-2.

  24. Sánchez JC, Romero CR, Muñoz LV, Rivera R. El órgano adiposo, un arcoiris de regulación metabólica y endocrina. Rev Cubana Endocrinol. 2016 [acceso: 09/09/2018]; 27(1). Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532016000100010&lng=es&nrm=iso&tlng=es

  25. Valdés Ramos E, Castillo Oliva Y, Valdés Bencosme E. Estimación del riesgo cardiovascular global en mujeres diabéticas de edad mediana. Rev Cubana Endocrinol. 2017 [acceso: 28/08/2018]; 28(3): 1-10. Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532017000300003&lng=es

  26. Sariol Y, Navarro D, Álvarez R, Armas Y, Domínguez E, Dopazo M. Etapas del climaterio y función endotelial en mujeres de edad mediana. Rev Cubana Endocrinol. 2015;26(2):138-46.

  27. Cabrera-Rego O, Navarro-Despaigne D, Staroushik-Morelc L, Díaz-Reyes K, Lima-Martínez M, Iacobellis G. Association between endothelial dysfunction, epicardial fat and subclinical atherosclerosis during menopause. Clin Investig Arterioscler. 2018;30(1):21-7.

  28. Salerni S, Francescomarino SQ, Cadeddu C, Acquistapace F, Maffei S, Callina S. The different role of sex hormones on female cardiovascular physiology and function: not only estrogens. Eur J Clin Invest. 2015;45 (6): 634-45.

  29. Bojar I, Gujski M, Rackzkiewcz D, Owoc J, Walecka I. Estradiol level and occurrence of atherosclerosis risk factors in healk thy postmenopausal women. Med Sci Monit. 2015:21;970-9.

  30. Dessapt AL, Gourdy P. Menopause and cardiovascular risk. J Gynecol Obstet Biol Reprod. 2012;41(7):13-9.

  31. Zambrana RE, Lopez L, Dinwiddie GY, Ray R, Phillips LS, Trevisan M, et al. Prevalence and incident prehypertension and hypertension in postmenopausal hispanic women: results from the womens health initiative. Am J Hypertension. 2014;27(3):372-81.

  32. Ramos L, Gallardo J, Cabrera J, Salgado L, Adam D, Mahía M. Riesgo aterogénico y enfermedades del corazón en mujeres de edad mediana. Rev Cubana Angiol. 2012;13(2):11-5.

  33. Zaydun G, Tomiyama H, Hashimoto H, Arai T, Koji Y, Yambe M, et al. Menopause is an independent factor augmenting the age-related increase in arterial stiffness in the early postmenopausal phase. Atherosclerosis. 2006;184(1):137-42.

  34. Wildman RP, Colvin AB, Powell LH, Matthews KA, Everson-Rose SA, Hollenberg S, et al. Associations of endogenous sex hormones with the vasculature in menopausal women: The Study of Women's Health Across the Nation (SWAN). Menopause. 2008;15(3):414-21.




2020     |     www.medigraphic.com