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Factors explaining the gender disparity in lipid-lowering treatment goal attainment rate in Chinese patients with statin therapy

机译:解释中国他汀类药物治疗患者降脂治疗目标达成率中性别差异的因素

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Background The lipid-lowering treatment goal attainment rate is lower for women than for men among Chinese patients, but the reasons for this disparity have not been fully explored yet. Objectives To elucidate the potential factors and the significance of their contributions towards the observed discrepancy in lipid-lowering treatment goal attainment rates between Chinese women and men. Methods We used data from 1808 patients from 21 tertiary and 6 secondary hospitals in China who received and maintained statin therapy treatment for at least 2?months. Lipid-lowering treatment goal attainment was defined as low-density lipoprotein cholesterol (LDL- C) reaching the treatment targets recommended by the Chinese Guidelines on Prevention and Control of Dyslipidemia in Adults. Logistic Regression was used to explore possible factors associated with gender disparity in goal attainment rates, and to what extent each factor contributes. Results A total of 674 women and 1134 men were enrolled in the study. Women had a significantly lower LDL-C goal attainment rate than that of men (46.0% vs 53.8%, P?=?0.002), particularly in high and very high CVD risk groups. Among high and very high risk patients, approximately 35%, 7%, 5%, and 5% of gender disparity in LDL-C goal attainment rate was attributable to the gender difference in baseline LDL-C level, cardiovascular co-morbidities and associated risk factors, socioeconomic status, and the dosage of statin treatment, respectively. Approximately 50% of the gender disparity remained unexplained by these factors. Conclusions Although nearly half of the gender disparity in lipid-lowering treatment goal attainment rate can be explained by the gender differences in baseline lipid level, socioeconomic status, cardiovascular co-morbidities and associated risk factors, and the dosage of statin in high and very high CVD risk patients, the other half of the gender disparity remains unexplained and requires further study to fully understand what other factors are at play.
机译:背景中国女性患者的降脂治疗目标达到率低于男性,但这种差异的原因尚未完全探讨。目的阐明潜在因素及其对中国男女之间降低脂类治疗目标达到率差异的贡献。方法我们使用了来自中国21家三级和六级二级医院的1808例接受和维持他汀类药物治疗至少2个月的患者的数据。达到降脂治疗目标的定义为达到《中国成人血脂异常防治指南》推荐的低密度脂蛋白胆固醇(LDL-C)。 Logistic回归用于探讨与目标实现率中的性别差异有关的可能因素,以及每个因素在何种程度上起作用。结果共有674名女性和1134名男性参加了研究。女性的LDL-C目标达成率明显低于男性(46.0%vs 53.8%,P≤0.002),尤其是在CVD风险高和非常高的人群中。在高危和高危患者中,LDL-C目标达成率的性别差异约占35%,7%,5%和5%,这归因于基线LDL-C水平,心血管合并症及相关因素的性别差异危险因素,社会经济状况和他汀类药物的治疗剂量。这些因素仍无法解释约50%的性别差异。结论虽然降脂治疗目标达到率的性别差异近一半可以通过基线血脂水平,社会经济状况,心血管合并症和相关危险因素的性别差异以及他汀类药物在高和极高人群中的剂量来解释患有CVD风险的患者,性别差异的另一半仍然无法解释,需要进一步研究以充分了解其他因素在起作用。

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