title: Gender difference in diabetes-associated risk of first-ever and recurrent ischemic stroke.
abstract: OBJECTIVE
  To evaluate the effect of diabetes by gender on the peak-risk of first-ever-ischemic stroke and its recurrence.
  
  
  METHODS
  Administrative datasets including all hospital discharges for ischemic stroke (N = 43,332) in the diabetic (N = 207,568) and non-diabetic (N = 2,808,554) population of the Tuscany region, Italy were used to calculate Hazard ratios (HR) after Cox-regression, of first-ever and recurrent ischemic strokes, between 2005 and 2011.
  
  
  RESULTS
  Overall, diabetes increased the HR of first-ever ischemic stroke by about 50% in both genders. However, this risk significantly declined with age and was higher in women aged 55-74 yr than in men of the same age (HR; 95% CI: 1.392; 1.228-1.579 in age-class 55-64 yr and 1.203; 1.110-1.304 in age class 65-74 yr; p < 0.001). Diabetes also increased the adjusted risk of three-year-stroke recurrence (N = 5,998) in women, independently of age, whereas this was the case in men < 70 yr.
  
  
  CONCLUSIONS
  Diabetes is associated with increased risk of ischemic stroke although it declines with age though at lower rate among women than men. Moreover, diabetic women have greater risk of recurrence than in men > 70 yrs old, supporting a high-risk "time-window" in postmenopausal-elderly diabetic women.
authors: Agenzia Regionale Sanità Toscana, Florence, Italy.
authors: Laura
authors: L
authors: Policardo
authors: Agenzia Regionale Sanità Toscana, Florence, Italy; Centre of Study for Gender Health Azienda USL 3, Pistoia, Italy. Electronic address: gseghier@tin.it.
authors: Giuseppe
authors: G
authors: Seghieri
authors: Agenzia Regionale Sanità Toscana, Florence, Italy.
authors: Paolo
authors: P
authors: Francesconi
authors: Centre of Study for Gender Health Azienda USL 3, Pistoia, Italy.
authors: Roberto
authors: R
authors: Anichini
authors: Department of Biomedical Sciences, University of Sassari, Sassari, Italy and Laboratory of Gender Medicine, National Institute of Biostructures and Biosystems, Osilo, Sassari, Italy.
authors: Flavia
authors: F
authors: Franconi
authors: Laboratorio Management e Sanità, Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy.
authors: Chiara
authors: C
authors: Seghieri
authors: Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Pisa, Italy.
authors: Stefano
authors: S
authors: Del Prato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D012737:Sex Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
keywords: Age; Diabetes; First-ever ischemic stroke; Gender; Hazard ratio; Recurrence