title: Does Gender Influence the Cardiovascular Benefits Observed with Sodium Glucose Co-Transporter-2 (SGLT-2) Inhibitors? A Meta-Regression Analysis.
abstract: BACKGROUND
  Although a large recent trial had shown improved cardiovascular outcomes of diabetic patients on sodium glucose co-transporter-2 (SGLT-2) inhibitors, the influence of gender differences on such outcomes is not known. Thus, we aimed to assess the impact of gender on such outcomes in the patients with type 2 diabetes mellitus receiving SGLT-2 inhibitors.
  
  
  METHODS
  A search of electronic databases was conducted for all randomized trials comparing SGLT-2 inhibitors with placebo in patients with diabetes mellitus. Primary outcomes were all-cause mortality and cardiovascular mortality. Random effects meta-regression was conducted using the percentage of women included in the SGLT-2 inhibitor arm of each trial with a P value of <0.1 for statistical significance.
  
  
  RESULTS
  A total of 22,256 patients from 26 trials were included. The overall odds ratio (OR) of all-cause mortality [OR = 0.72, 95% confidence interval (CI) 0.60-0.86, P < 0.001, I2= 0%], and cardiovascular mortality (OR = 0.67, 95% CI 0.53-0.84, P = 0.001, I2= 23%) were lower with SGLT-2 inhibitors. Meta-regression suggested a possible incremental increase in the OR for all-cause mortality and cardiovascular mortality as the percentage of women in the SGLT-2 inhibitor arm increased (P = 0.07 and 0.08, respectively).
  
  
  CONCLUSIONS
  Gender might influence the cardiovascular benefits observed with SGLT-2 inhibitors in patients with type 2 diabetes mellitus.
authors.affiliation: Department of Medicine, University of Florida, Gainesville, FL, USA. Ahmed.Mahmoud@medicine.ufl.edu.
authors.forename: Ahmed N
authors.initials: AN
authors.lastname: Mahmoud
authors.affiliation: Department of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: Islam Y
authors.initials: IY
authors.lastname: Elgendy
authors.affiliation: Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Marwan
authors.initials: M
authors.lastname: Saad
authors.affiliation: Department of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: Akram Y
authors.initials: AY
authors.lastname: Elgendy
authors.affiliation: Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Amr F
authors.initials: AF
authors.lastname: Barakat
authors.affiliation: Department of Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Amgad
authors.initials: A
authors.lastname: Mentias
authors.affiliation: Division of Cardiovascular Medicine, Sidney Kimmel Medical College at Thomas Jefferson University/Christiana Care Health Delaware, Newark, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abuzaid
authors.affiliation: Department of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Bavry
keywords: Diabetes mellitus; Incretins; Meta-regression; Mortality; Outcomes