title: Differential sex effects of systolic blood pressure and low-density lipoprotein cholesterol on type 2 diabetes: Life course data from the Bogalusa Heart Study.
abstract: BACKGROUND
  There may be sex-specific cardiometabolic mechanisms early in life that affect the development of type 2 diabetes mellitus (T2DM) through mid-adulthood. However, few studies have examined whether early life course interactions between cardiometabolic risk factors and sex are associated with incident T2DM.
  
  
  METHODS
  This study followed 7725 children (3834 [49.6%] females, 3891 [50.4%] males) from the Bogalusa Heart Study through mid-adulthood to examine whether low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), body mass index (BMI), or systolic blood pressure (SBP) differentially affect the risk of T2DM for females versus males. Potential sex interactions were tested after adjusting for age, race, triglycerides, smoking, follow-up time, puberty stage, use of birth control, and enrollment year.
  
  
  RESULTS
  Mean (± SD) age at baseline was 9.4 ± 3.5 years. There were 176 cases of T2DM (cumulative incidence = 2.3%) during a median follow-up of 9.1 years. In females versus males, LDL-C and SBP were differentially associated with T2DM (P ≤ 0.001 and P = 0.017, respectively). The relationships of BMI and HDL-C with T2DM were non-differential between females and males (P = 0.79 and P = 0.27, respectively).
  
  
  CONCLUSIONS
  This study is the first to show evidence of sex-specific differential effects of LDL-C and SBP on the risk of T2DM from childhood to adulthood. Greater LDL-C places girls at disproportionally higher risk of T2DM as women, whereas greater SBP differentially exposes boys to a greater risk of T2DM as men. Additional studies within existing child cohorts are needed to confirm and investigate the mechanisms underlying these differential effects.
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Pollock
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Harville
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Tian
authors.initials: T
authors.lastname: Shu
authors.affiliation: Department of Endocrinology, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
authors.affiliation: Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Franck
authors.initials: F
authors.lastname: Mauvais-Jarvis
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Tanika N
authors.initials: TN
authors.lastname: Kelly
authors.affiliation: Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Bazzano
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055820:New Orleans / Q000453:epidemiology; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL
keywords: 2型糖尿病; interaction; life course epidemiology; metabolic cardiovascular syndrome; sex; type 2 diabetes mellitus; 交互作用; 代谢性心血管综合征; 性别; 生命历程流行病学