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. 2021 Jun 1;28(6):604-610.
doi: 10.5551/jat.56531. Epub 2020 Sep 10.

The Elderly with Glucose-6-Phosphate Dehydrogenase Deficiency are More Susceptible to Cardiovascular Disease

Maria Pina Dore  1   2 , Michele Portoghese  3 , Giovanni Mario Pes  1   4
Affiliations

The Elderly with Glucose-6-Phosphate Dehydrogenase Deficiency are More Susceptible to Cardiovascular Disease

Maria Pina Dore et al. J Atheroscler Thromb. .

Abstract

Aim: Recent studies suggest that glucose-6-phosphate dehydrogenase (G6PD) deficiency, a genetically inherited condition causing hemolytic anemia, may be a risk factor for cardiovascular disease (CVD). We aimed to perform a retrospective case-control study in Sardinia taking advantage from clinical records of patients undergoing upper digestive endoscopy and screened for H. pylori infection.

Methods: A total of 9,604 patients with a known G6PD status and a complete clinical history, encompassing CVD, and leading CVD risk factors, including H. pylori infection, undergoing upper endoscopy between 2002 and 2017 were enrolled in this study.

Results: Multivariate logistic regression analysis confirmed an increased CVD risk in subjects with G6PD deficiency [odd ratio (OR), 3.24; 95% confidence interval (CI) 2.44-4.30] after adjusting for potential confounders and effect modifiers, including H. pylori infection. Cardiovascular risk was similar in subjects with and without G6PD deficiency before age 60 (OR, 1.26; 95% CI 0.78-2.04, P=0.562), whereas it increased after age 60 in the former group (OR, 3.05; 95% CI 2.22-4.19, P＜0.0001) especially in males (OR 3.67; 95% CI 2.19-6.14) compared with females (OR, 2.96; 95% CI 1.89-4.64) by sex-specific logistic regression analysis.

Conclusion: The risk of CVD was greater in G6PD-deficient subjects after age 60, both in males and females, than those with normal enzyme activity, after adjusting for conventional CVD risk factors and H. pylori infection. The reduction of important protective mechanisms against oxidative stress in the elderly might explain the study findings.

Keywords: Antioxidant defense; Cardiovascular disease; Glucose-6-phosphate dehydrogenase; Helicobacter pylori.

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Figures

Fig. 1. Odds ratios for cardiovascular disease (CVD) according to age decades in 9,604 patients with (1,123) and without (8,481) G6PD deficiency
Fig. 1. Odds ratios for cardiovascular disease (CVD) according to age decades in 9,604 patients with (1,123) and without (8,481) G6PD deficiency
Logistic regression analysis was performed with CVD as the dependent binary (presence/absence) variable and G6PD status as the main pre- dictor variable, separately on each age decade. Odds ratios significantly diverged from unity after the sixth decade for the presence of CVD in patients with G6PD deficiency. ＊ P ＜0.0001
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