Thomas Candice M, Smart Eric J
Department of Pediatrics and Kentucky Pediatric Research Institute, University of Kentucky, Lexington, Kentucky 40536, USA.
Curr Drug Targets. 2007 Nov;8(11):1172-80. doi: 10.2174/138945007782403874.
The risk of development and progression of atherosclerosis is different between males and females. Premenopausal women have a lower risk of developing atherosclerosis and cardiovascular disease than men. However, after the onset of menopause the protection associated with gender is lost and the risk of women developing atherosclerosis gradually approaches that of men. In an effort to treat the elevated risk of cardiovascular disease in postmenopausal women, hormone replacement therapy has been used. However, the results of the randomized trials of the Women's Health Initiative indicated that hormone replacement therapy may not be cardioprotective. The use of mouse models have aided in the understanding of atherosclerosis for many years. These models along with the gender effects attributed to sex hormones are being used to generate a more complete understanding of the development of atherosclerosis. Mice lacking one or both of the genes for estrogen receptors have highlighted the role of estrogen in atherosclerosis. In addition to estrogen, the effects of testosterone have been researched in many animal models and several mechanisms incorporating its role in cholesterol homeostasis have emerged. Our understanding of the pathways involved in gender effects on cardiovascular disease is incomplete, however, a plethora of animal models offer the opportunity to dissect the molecular mechanisms involved.
动脉粥样硬化的发生和进展风险在男性和女性之间存在差异。绝经前女性患动脉粥样硬化和心血管疾病的风险低于男性。然而,绝经后,与性别相关的保护作用丧失,女性患动脉粥样硬化的风险逐渐接近男性。为了治疗绝经后女性心血管疾病风险升高的问题,人们使用了激素替代疗法。然而,妇女健康倡议的随机试验结果表明,激素替代疗法可能没有心脏保护作用。多年来,小鼠模型有助于人们对动脉粥样硬化的理解。这些模型以及归因于性激素的性别效应正被用于更全面地理解动脉粥样硬化的发展。缺乏一个或两个雌激素受体基因的小鼠突出了雌激素在动脉粥样硬化中的作用。除了雌激素,睾酮的作用也在许多动物模型中进行了研究,并且出现了几种包含其在胆固醇稳态中作用的机制。然而,我们对性别影响心血管疾病所涉及途径的理解并不完整,不过,大量的动物模型提供了剖析其中分子机制的机会。