Exposure to type 2 diabetes and risk of coronary heart disease in Chinese men and women: findings from a cross-sectional national survey

Abstract Background Coronary heart disease generally occurs more frequently in men than in women. Findings from small studies (n Methods We did a cross-sectional national survey in 223 612 Chinese patients (age ≥18 years; 120 252 men and 103 360 women) with type 2 diabetes in 630 hospitals from 106 cities in 30 provinces of China in 2012. Demographic information, medical history, and drug use were documented. Coronary heart disease was defined as ischaemic heart disease with abnormal electrocardiogram (ECG) or stress test, myocardial infarction with typical changes in ECG and plasma enzyme testing, coronary revascularisation, percutaneous transluminal coronary angioplasty, or coronary atherectomy. We used multivariable binary logistic regression analysis to obtain odds ratios (ORs) for coronary heart disease in women versus men, controlling for age, hospital level, BMI, glucose monitoring at home, diabetes medications, diabetic nephropathy, HbA 1c , systolic blood pressure, diastolic blood pressure, LDL cholesterol, HDL cholesterol, and triglyceride. We used additive interaction to test whether sex and exposure time to diabetes had a synergistic effect on the risk of coronary heart disease. Ethics approval was granted by the Ethics Committee of the Chinese Peopleu0027s Libration Army General Hospital, and all participants provided written informed consent. Findings Compared with men, women had lower HbA 1c , lower systolic and diastolic blood pressure, and similar low-density lipoprotein cholesterol levels. However, 11 684 (11·3%) of 103 360 women who had type 2 diabetes had coronary heart disease, compared with 12 758 (10·6%) of 120 252 men (p Interpretation Exposure to type 2 diabetes for 15 years or more imparts a larger risk of coronary heart disease to Chinese women than to Chinese men. The excessive risk in women could not be explained by conventional risk factors of coronary heart disease. Funding Novo Nordisk China.