Clinical Risk Factors Differ by Sex for Kidney Complications but Not Retinopathy in Type 1 Diabetes: The Pittsburgh Epidemiology of Diabetes Complications Cohort
Authors' conclusion
Although HbA1c and BP are important risk factors for retinopathy regardless of sex, sex-specific clinical targets warrant further research to optimize kidney protection in type 1 diabetes.
Study context
- Population
- Adults with T1D in the Pittsburgh Epidemiology of Diabetes Complications cohort; mean baseline age 27 years, diabetes duration 19 years; followed 1986–1988 to 2016–2018
- Participants
- 325 vs 333
- Exposure
- Women vs men
- Womenn = 325
- Menn = 333reference
- Outcome
- Incident PDR, severely increased albuminuria (SIA; AER ≥200 µg/min) and CKD G3 (eGFR <60 mL/min/1.73 m²)
- Follow-up
- 30 years
Methodological detailssex-specific analysis, multivariable joint models
- Sex-specific analysis
- Multivariable joint models
Main finding
As reported in the abstract
Incidence of PDR, SIA and CKD G3 by sex
- Proliferative diabetic retinopathy (PDR) incidence: Women 57% vs Men 59%, P = 0.54
- Severely increased albuminuria (SIA) incidence: Women 18% vs Men 25%, P = 0.10
- CKD G3: Women 28% vs Men 21%, P = 0.11
Observational data: associations, not effects.
Further findings
Risk factors for PDR
| HR (95% CI) | ||
|---|---|---|
| Women: systolic BP | 1.27 (1.12–1.45) | |
| Men: diastolic BP | 1.40 (1.15–1.70) | |
| 0.512Hazard ratio (log scale) |
| Outcome | HR (95% CI) | |
|---|---|---|
| Risk factors for SIAWomen: triglyceride levels (per log1.2) | 1.38 (1.06–1.78) | |
| 0.512Hazard ratio (log scale) |
Risk factors for SIA
| HR (95% CI) | ||
|---|---|---|
| Women: BMI | 0.87 (0.76–1.00) | |
| Men: smoking | 3.46 (1.07–11.24) | |
| 0.050.21520Hazard ratio (log scale) |
Risk factors for PDR
- HbA1c and blood pressure (BP) independent risk factors for PDR in both sexes
Risk factors for SIA
- HbA1c associated with SIA in both sexes
Risk factors for CKD G3
- HbA1c a risk factor in both sexes; smoking also associated in men
Original publication
Clinical Risk Factors Differ by Sex for Kidney Complications but Not Retinopathy in Type 1 Diabetes: The Pittsburgh Epidemiology of Diabetes Complications Cohort. Diabetes Care. Published 4 June 2026. doi:10.
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