The reduction of myocardial infarction (MI) and narrowing the gap between the populations with and without diabetes are important goals of diabetes care. We analyzed time trends for sex-specific incidence rates (IR) of first MI (both non-fatal MI and fatal MI) as well as separately for first non-fatal MI and fatal MI in the population with and without diabetes. Using data from the KORA myocardial infarction registry (Augsburg, Germany), we estimated age-adjusted IR in people with and without diabetes, corresponding relative risks (RR), and time trends from 1985 to 2016 using Poisson regression. There were 19,683 people with first MI (34% fatal MI, 71% men, 30% with diabetes) between 1985 and 2016. In the entire study population, the IR of first MI decreased from 359 (95% CI: 345–374) to 236 (226–245) per 100,000 person years. In men with diabetes, IR decreased only in 2013–2016. This was due to first non-fatal MI, where IR in men with diabetes increased until 2009–2012, and slightly decreased in 2013–2016. Overall, fatal MI declined stronger than first non-fatal MI corresponding to IRs. The RR of first MI substantially increased among men from 1.40 (1.22–1.61) in 1985–1988 to 2.60 (2.26–2.99) in 1997–2000 and moderately decreased in 2013–2016: RR: 1.75 (1.47–2.09). Among women no consistent time trend for RR was observed. Time trends for RR were similar regarding first non-fatal MI and fatal MI. Over the study period, we found a decreased incidence of first MI and fatal MI in the entire study population. The initial increase of first non-fatal MI in men with diabetes needs further research. The gap between populations with and without diabetes remained.

中文翻译：

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1985 年至 2016 年德国某地区糖尿病患者和非糖尿病患者首次心肌梗死发病率的性别趋势

减少心肌梗塞（MI）并缩小糖尿病患者与非糖尿病人群之间的差距是糖尿病护理的重要目标。我们分析了首次心肌梗死（非致命性心肌梗死和致命性心肌梗死）的性别特异性发病率（IR）的时间趋势，并分别分析了患有和不患有糖尿病的人群中首次非致命性心肌梗死和致命性心肌梗死的时间趋势。使用 KORA 心肌梗死登记处（德国奥格斯堡）的数据，我们使用泊松回归估计了糖尿病患者和非糖尿病患者的年龄调整 IR、相应的相对风险 (RR) 以及 1985 年至 2016 年的时间趋势。 1985 年至 2016 年间，有 19,683 人首次发生心肌梗死（34% 致命性心肌梗死，71% 为男性，30% 患有糖尿病）。在整个研究人群中，首次心肌梗死的 IR 从 359 下降（95% CI：345-374）到每 100,000 人年 236 (226–245)。在患有糖尿病的男性中，IR 仅在 2013 年至 2016 年期间有所下降。这是由于首次非致命性心肌梗死所致，男性糖尿病患者的 IR 在 2009 年至 2012 年之前一直呈上升趋势，而在 2013 年至 2016 年期间略有下降。总体而言，致命性 MI 的下降幅度强于 IR 对应的首次非致命性 MI。男性首次心肌梗死的 RR 从 1985-1988 年的 1.40 (1.22-1.61) 大幅增加到 1997-2000 年的 2.60 (2.26-2.99)，并在 2013-2016 年适度下降：RR：1.75 (1.47-2.09)。在女性中，没有观察到 RR 的一致时间趋势。首次非致命性 MI 和致命性 MI 的 RR 时间趋势相似。在研究期间，我们发现整个研究人群中首次心梗和致命心梗的发生率有所下降。男性糖尿病患者首次非致命性心梗的最初增加需要进一步研究。患有糖尿病和未患糖尿病的人群之间的差距仍然存在。