title: Gender effect on the relation between diabetes and hospitalization for heart failure.
abstract: OBJECTIVE
  Cardiovascular risk among diabetic patients is at least twice as much the one for non-diabetic individuals and even greater when diabetic women are considered. Heart failure (HF) is a common unfavorable outcome of cardiovascular disease in diabetes. However, since the comparison among sexes of heart failure prevalence in diabetic patients remains limited, this study is aimed at expanding the information about this point.
  
  
  METHODS
  We have evaluated the association between diabetes and HF by reviewing the medical records of all subjects discharged from the Internal Medicine and Cardiology Units of all hospitals in the Tuscany region, Italy, during the period January 2002 through December 2008. In particular we sought concomitance of ICD-9-CM codes for diabetes and HF.
  
  
  RESULTS
  Patients discharged by Internal Medicine were on average older, more represented by women, and had a lesser number of individuals coded as diabetic (p<0.05 for all). Relative risk for HF (95% CI) was significantly higher in patients with diabetes, irrespective of gender 1.39 (1.36-1.41) in males; 1.40 (1.37-1.42) in females. When the diabetes-HF association was analyzed according to decades of age, a "horse-shoe" pattern was apparent with an increased risk in 40-59 years old in female patients discharged by Internal Medicine.
  
  
  CONCLUSIONS
  Although there is not a difference in the overall HF risk between hospitalized male and female diabetic patients, women have an excess risk at perimenopausal age.
authors.affiliation: Scuola Superiore S. Anna, MES Laboratory, University of Pisa, Pisa, Italy. gseghier@tin.it
authors.forename: C
authors.initials: C
authors.lastname: Seghieri
authors.forename: P
authors.initials: P
authors.lastname: Francesconi
authors.forename: S
authors.initials: S
authors.lastname: Cipriani
authors.forename: M
authors.initials: M
authors.lastname: Rapanà
authors.forename: R
authors.initials: R
authors.lastname: Anichini
authors.forename: F
authors.initials: F
authors.lastname: Franconi
authors.forename: S
authors.initials: S
authors.lastname: Del Prato
authors.forename: G
authors.initials: G
authors.lastname: Seghieri
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D048909:Diabetes Complications / Q000453:epidemiology* / Q000503:physiopathology; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics