***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The purpose of our study was to confirm or refute the view that diabetes be regarded as a coronary heart disease ( CHD ) risk equivalent and to test for sex differences in mortality . RESEARCH DESIGN AND METHODS This was a prospect i ve cohort study of 7,052 men and 8,354 women aged 45 - 64 years from Renfrew and Paisley , Scotl and , who were first screened in 1972 - 1976 and followed for 25 years .  All-cause mortality was calculated as death per 1,000 person-years . A Cox proportional hazards model was used to adjust survival for age , smoking habit , blood pressure , serum cholesterol , BMI , and social class . RESULTS There were 192 deaths in 228 subjects with diabetes and 2,016 deaths in 3,076 subjects with CHD . The highest mortality was in the group with both diabetes and CHD ( 100.2 deaths/1,000 person-years in men , 93.6 in women ) and the lowest in the group with neither ( 29.2 deaths/1,000 person-years in men , 19.4 in women ) . Men and women with diabetes only and CHD only formed an intermediate risk group . The adjusted hazard ratio ( HR ) for CHD mortality in men with diabetes only compared with men with CHD only was 1.17 ( 95 % CI 0.78 - 1.74 ; P = 0.56 ) . Corresponding HR for women was 1.97 ( 1.27 - 3.08 ; P = 0.003 ) . CONCLUSIONS Diabetes without previous CHD carries a lifetime risk of vascular death as high as that for CHD alone . Women may be at particular risk . Our data support the view that cardiovascular risk factors in diabetes should be treated as aggressively as in people with CHD Background Coronary heart disease ( CHD ) is one of the most common long-term complications in people with type 2 diabetes . We analyzed whether or not gender differences exist in diabetes and CHD medication among people with type 2 diabetes . Methods The study was based on data from the baseline examination of the DIANA study , a prospect i ve cohort study of 1,146 patients with type 2 diabetes conducted in South-West Germany . Information on diabetes and CHD medication was obtained from the physician question naires . Bivariate and multivariate analyses using logistic regression were employed in order to assess associations between gender and prescribed drug classes . Results In total , 624 men and 522 women with type 2 diabetes with a mean age of 67.2 and 69.7 years , respectively , were included in this analysis . Compared to women , men had more angiopathic risk factors , including smoking , alcohol consumption and worse glycemic control , and had more often a diagnosed CHD . Bivariate analyses showed higher prescription of thiazolidinediones and oral combination drugs  as well as of  angiotensin-converting enzyme ( ACE ) inhibitors , calcium channel blockers and aspirin  in men than in women . After full adjustment , differences between men and women remained significant only for ACE inhibitors ( OR = 1.44 ; 95%-confidence interval ( CI ) : 1.11 – 1.88 ) and calcium channel blockers ( OR = 1.42 , 95%-CI : 1.05 – 1.91 ) . Conclusions These findings contribute to current discussion s on gender differences in diabetes care . Men with diabetes are significantly more likely to receive  oral combination drugs , ACE inhibitors and calcium channel blockers  in the presence of coronary heart disease , respectively . Our results suggest , that diabetic men might be more thoroughly treated compared to women . Further research is needed to focus on reasons for these differences mainly in treatment of cardiovascular diseases to improve quality of care OBJECTIVE —Cardiovascular disease ( CVD ) mortality has decreased in men but not in women with diabetes . We investigated whether sex differences in control and treatment of CVD risk factors might underlie this disparity . RESEARCH DESIGN AND METHODS —We performed cross-sectional analyses from a cohort of patients with diabetes sample d from 10 U.S. managed care health plans . Study end points included not being in control for CVD risk factors ( ≥140 mmHg for systolic blood pressure [ SBP ] , ≥3.35 mmol/l for LDL cholesterol , and ≥8.0 % for A1C ) and the intensity of medication management ( number of medication classes ) for patients not in control . Logistic regression models with r and om intercepts were used to adjust probabilities of control and management for demographics , clinical characteristics , and clustering within health plans . RESULTS —There were 1,315 women and 1,575 men with a history of CVD and 3,415 women and 2,516 men without a history of CVD . Among patients with CVD , adjusted estimated probabilities for not being in control and risk differences varied significantly between men and women for SBP ( men 41.2 % , women 46.6 % ; risk difference −5.4 % [ 95 % CI −9.5 to −1.3 ] ) and LDL cholesterol ( men 22.4 % , women 28.3 % ; risk difference −5.9 % [ −9.9 to −1.8 ] ) . There were no significant sex differences in intensity of medication management for patients not in control . In patients without CVD there were no significant differences in control or intensity of medication management . CONCLUSIONS —In diabetic patients with CVD , poorer control of SBP and LDL cholesterol for women may contribute to the sex disparity in CVD mortality trends OBJECTIVE To correlate anthropometric , computed tomography and fat cell data from abdominal regions with the levels of serum insulin , C-peptide , leptin , tumor necrosis factor-alpha ( TNF-alpha ) , testosterone , 17beta-estradiol , and rostenedione , dehydroepi and rosterone sulphate ( DHEA-S ) and sex hormone-binding globulin ( SHBG ) . DESIGN AND METHODS The sample consisted of 84 obese patients ( 29 men , 22 premenopausal women and 33 postmenopausal women ) who had undergone abdominal surgery .  Weight , height , percentage of body fat by skinfolds , waist , hip and thigh circumferences , sagittal and coronal diameters , visceral and subcutaneous area , serum hormones and fat cell data were studied . RESULTS AND CONCLUSIONS Premenopausal women showed the lowest values in most abdominal distribution parameters , although , depending on the waist circumference criteria at the umbilicus level perimeter ( W1 ) or midway between lower rib margin and iliac crest perimeter ( W2 ) , the population was classified differently , as gynoid or and roid . Although there were no differences in fat cell size between genders , gynoid women had smaller and more numerous fat cells than the and roid type . Perivisceral fat cell size was significantly smaller than subcutaneous fat cell size . In women , central obesity was significantly correlated with an increase in serum insulin , leptin , TNF-alpha , testosterone and and rostenedione levels , and a decrease in 17beta-estradiol and DHEA-S , while in men significant correlations were positive with insulin and negative with testosterone and and rostenedione . Fat cell size was positively correlated with serum levels of leptin , insulin , DHEA-S , and rostenedione and inversely correlated with SHBG . These data indicate that hormones seem to interact not only with body fat distribution but also with fat cell size . This interaction differs between genders and between the different abdominal adipose tissue regions This report describes the plan and operation of the third National Health and Nutrition Examination Survey . The sample for this study of the U.S. population was selected from households in 81 counties across the United States . About 40,000 persons 2 months of age and over were selected , including large sample s of both young and old persons . About 12,000 of the sample persons were black Americans , 12,000 were Mexican-Americans , and the remaining 16,000 were of all other race and ethnicity groups . All selected persons were asked to complete an extensive interview and an examination in a large mobile examination center . The survey period is 1988 - 94 , consisting of two phases of equal length and sample size . Both Phase 1 and Phase 2 were r and om sample s of the U.S. population living in households BACKGROUND Studies on coronary risk factors in men and women are mainly based on mortality data and few compare results of both sexes with consistent study design and diagnostic criteria . This study assesses the major risk factors for coronary events in men and women from the Reykjavik Study . DESIGN Within a prospect i ve , population -based cohort study individuals without history of myocardial infa rct ion were identified and the relative risk of baseline variables was assessed in relation to verified myocardial infa rct ion or coronary death during follow-up . METHODS Of the 9681 women and 8888 men who attended risk assessment from 1967 - 1991 , with follow-up period of up to 28 years , 706 women and 1700 men suffered a non-fatal myocardial infa rct ion or coronary death . RESULTS Serum cholesterol was a significant risk factor for both sexes , with hazard ratios ( HR ) decreasing with age . Systolic blood pressure was a stronger risk factor for women as was ECG-confirmed left ventricular hypertrophy ( women HR 2.89 , 95 % confidence interval [ CI ] 1.67 - 5.01 ; men HR 1.11 [ CI 0.86 - 1.43 ] ) . Fasting blood glucose > or = 6.7 mmol/L identified significantly higher risk for women ( HR 2.65 ) than men ( HR 2.08 ) as did self-reported diabetes . Triglyceride risk was significantly higher for women and decreased significantly with age . Smoking increased risk two- to five-fold , increasing with dose , for women , which was significantly higher than the doubling in risk for men . CONCLUSIONS This large study of the major risk factors compared between the sexes demonstrates similar relative risk of myocardial infa rct ion associated with cholesterol for both sexes , however , the relative risk is higher in women for many other risk factors such as smoking , diabetes , elevated triglycerides and left ventricular hypertrophy BACKGROUND Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white population s. In this investigation , we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks . METHODS Data collected over a 30-year period in the Charleston Heart Study were used to estimate mortality rates and quantify associations with risk factors assessed at the base-line examination in 1960 and 1961 of 653 white men , 333 black men , 741 white women , and 454 black women . RESULTS There were no significant racial differences in the rate ratios for death from coronary disease ; however , women had significantly lower death rates than men . Over the 30-year period , the mortality rates for coronary disease per 1000 person-years were 5.2 for white men ( 95 percent confidence interval , 4.1 to 6.3 ) , 4.6 for black men ( 3.0 to 6.2 ) , 2.1 for white women ( 1.6 to 2.6 ) , and 3.2 for black women ( 2.3 to 4.0 ) . Significant , or nearly significant , predictors of mortality due to coronary disease were systolic blood pressure in all four groups ; serum cholesterol level among white men , white women , and black women ; and smoking among white men , white women , and black men . Although the difference was not statistically significant , the risk of death from coronary disease was consistently increased among diabetics in all four groups . A higher level of education was predictive of lower rates of death due to coronary disease among white men and black women . For all causes of death taken together , the rates for blacks were higher than the rates for whites . The presence of hypertension , a history of smoking , and a history of diabetes were significant or nearly significant predictors of mortality from any cause in all four groups . CONCLUSIONS Although the rates of death from coronary disease were somewhat lower among black men than white men and higher among black women than white women , the black : white mortality rate ratios were not statistically significant , and the major risk factors for mortality from coronary disease were similar in blacks and whites in the 30-year follow-up of the Charleston Heart Study A new prospect i ve study of non-institutionalised Australian elderly 60 years and over commenced in Dubbo in 1988 , comprising 1236 men and 1569 women . This report examines clinical and socio-demographic predictors of coronary heart disease ( CHD ) over a median 62 months follow-up . CHD incidence rates ( ICD-9-CM codes 410 - 414 ) were higher in men than women until 79 years , thereafter , the rates for recurrent disease were higher in women . Incidence rates for recurrent disease were three-fold those for initial disease . In Cox proportional hazards analysis , the significant predictors of all CHD were : advancing age , prior CHD ( relative risk ( RR ) = 2.50 and 2.15 in men and women , respectively ) , use of anti-hypertensive medication ( RR = 1.92 and 1.75 in men and women , respectively ) . diabetes ( R 
    Output:
    
Conclusions /interpretationWomen with diabetes have more than a 40 % greater risk of incident CHD compared with men with diabetes .