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Breyer MK, Ofenheimer A, Altziebler J, Hartl S, Burghuber OC, Studnicka M, Purin D, Heinzle C, Drexel H, Franssen FME, Wouters EFM, Harreiter J, Kautzky-Willer A, Breyer-Kohansal R. Marked differences in prediabetes- and diabetes-associated comorbidities between men and women-Epidemiological results from a general population-based cohort aged 6-80 years-The LEAD (Lung, hEart, sociAl, boDy) study. Eur J Clin Invest 2020; 50:e13207. [PMID: 31997311 DOI: 10.1111/eci.13207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 12/29/2019] [Accepted: 01/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Based on biological and behavioural diversity sex and gender may affect comorbidities associated with prediabetes and diabetes. Besides evaluating the prevalence of prediabetes and diabetes (using fasting plasma glucose and HbA1c levels), the primary aim of the study is to investigate sex and gender differences in the prevalence of comorbidities in subjects with prediabetes and diabetes and to identify possible risk factors associated with prediabetes and diabetes. DESIGN This observational, population-based cohort study included 11.014 subjects aged 6-80 years. Examinations included blood samples, ankle-brachial index, ECG, dual-energy X-ray absorptiometry scan and an interviewer-administered questionnaire. RESULTS Across all ages, prevalence of prediabetes was 20.2% (male 23.6%; female 17.1%), and 5.4% for diabetes (male 7.3%; female 3.7%). The prevalence of prediabetes ranged from 4.4% (6-<10 years) up to 40.4% (70+ years) in men and from 4.8% up to 42.3% in women. Comorbidity profile was markedly different between male and female, particularly in those with prediabetes: women more often suffered from arrhythmia, noncoronary artery disease, osteoporosis, increased systemic inflammatory biomarkers and depression, while men with prediabetes more often showed angina pectoris, myocardial infarction and media sclerosis. CONCLUSIONS The unexpected 4.6% prevalence of prediabetes in children aged 6-10 underscores the need for population-based studies across all ages and the onset of prevention of diabetes at a young age. Marked differences have been found in comorbidities as men with prediabetes and diabetes more often suffer from cardiovascular disease, while women more often show arrhythmia, noncoronary artery disease, increased systemic inflammatory biomarkers and depression.
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Affiliation(s)
- Marie-Kathrin Breyer
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Alina Ofenheimer
- Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Julia Altziebler
- Karl Landsteiner University, Human Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Sylvia Hartl
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.,Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Otto C Burghuber
- Sigmund Freud University, Medical School and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Michael Studnicka
- Department of Respiratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Daniela Purin
- Vivit-Institute, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Christine Heinzle
- Vivit-Institute, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Heinz Drexel
- Vivit-Institute, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Frits M E Franssen
- Department of Respiratory Medicine+, MUMC+, Maastricht University, Maastricht, The Netherlands
| | - Emiel F M Wouters
- Department of Respiratory Medicine+, MUMC+, Maastricht University, Maastricht, The Netherlands
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Robab Breyer-Kohansal
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
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Fixen CW, Fixen DR. Managing and maintaining bone mineral density in diabetes patients with pharmacotherapy. Expert Opin Pharmacother 2017; 18:2001-2006. [PMID: 29172834 DOI: 10.1080/14656566.2017.1410539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The population of patients with osteoporosis and diabetes is increasing as the aging population increases. Loss of bone mineral density occurs in patients with diabetes, but is not always a priority in the practice setting. The aim of this review is to discuss clinical considerations when managing osteoporosis in patients with diabetes. Areas covered: The pathophysiology of decreased bone mineral density in patients with diabetes is discussed. Additionally, diabetic risk factors for fracture, such as hypoglycemia, the National Osteoporosis Foundation recommendations for osteoporosis, and secondary causes of osteoporosis, including disease and medication related causes, are discussed. Furthermore, recommendations for antihyperglycemic agents, thiazolidinediones, canagliflozin, insulin, metformin, and sitagliptin are discussed due to their effects on bone mineral density. Expert opinion: Even though diabetes is an important risk factor for osteoporosis, assessing bone health in diabetic patients is often overlooked. Ensuring adequate prevention and treatment strategies for osteoporosis is vitally important with our diabetic patients as the population ages. T-scores and FRAX scores likely underrepresent a diabetic patients risk for fracture, and this should be taken into consideration in treatment decisions. Future studies are needed to determine optimal pharmacologic treatment of hyperglycemia in this population.
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Affiliation(s)
- Cy W Fixen
- a Denver Veterans Affairs Medical Center , Denver , CO , USA
| | - Danielle R Fixen
- b Department of Clinical Pharmacy , University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences , Aurora , USA
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