心血管代谢生物标志物的性别差异。
Sex-Based Differences in Cardiometabolic Biomarkers.
作者信息
Lew Jeanney, Sanghavi Monika, Ayers Colby R, McGuire Darren K, Omland Torbjørn, Atzler Dorothee, Gore Maria O, Neeland Ian, Berry Jarett D, Khera Amit, Rohatgi Anand, de Lemos James A
机构信息
From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.).
出版信息
Circulation. 2017 Feb 7;135(6):544-555. doi: 10.1161/CIRCULATIONAHA.116.023005.
BACKGROUND
Few data are available comparing cardiovascular disease (CVD) biomarker profiles between women and men in the general population. We analyzed sex-based differences in multiple biomarkers reflecting distinct pathophysiological pathways, accounting for differences between women and men in CVD risk factors, body composition, and cardiac morphology.
METHODS
A cross-sectional analysis was performed using data from the Dallas Heart Study, a multiethnic population-based study. Associations between sex and 30 distinct biomarkers representative of 6 pathophysiological categories were evaluated using multivariable linear regression adjusting for age, race, traditional CVD risk factors, kidney function, insulin resistance, MRI and dual-energy x-ray absorptiometry measures of body composition and fat distribution, and left ventricular mass.
RESULTS
After excluding participants with CVD, the study population included 3439 individuals, mean age 43 years, 56% women, and 52% black. Significant sex-based differences were seen in multiple categories of biomarkers, including lipids, adipokines, and biomarkers of inflammation, endothelial dysfunction, myocyte injury and stress, and kidney function. In fully adjusted models, women had higher levels of high-density lipoprotein cholesterol and high-density lipoprotein particle concentration, leptin, d-dimer, homoarginine, and N-terminal pro B-type natriuretic peptide, and lower levels of low-density lipoprotein cholesterol, adiponectin, lipoprotein-associated phospholipase A2 mass and activity, monocyte chemoattractant protein-1, soluble endothelial cell adhesion molecule, symmetrical dimethylarginine, asymmetrical dimethylarginine, high-sensitivity troponin T, and cystatin C.
CONCLUSIONS
Biomarker profiles differ significantly between women and men in the general population. Sex differences were most apparent for biomarkers of adiposity, endothelial dysfunction, inflammatory cell recruitment, and cardiac stress and injury. Future studies are needed to characterize whether pathophysiological processes delineated by these biomarkers contribute to sex-based differences in the development and complications of CVD.
背景
在普通人群中，比较男性和女性心血管疾病（CVD）生物标志物谱的数据较少。我们分析了反映不同病理生理途径的多种生物标志物的性别差异，同时考虑了男性和女性在CVD危险因素、身体组成和心脏形态方面的差异。
方法
使用达拉斯心脏研究的数据进行横断面分析，该研究是一项基于多民族人群的研究。使用多变量线性回归评估性别与代表6种病理生理类别的30种不同生物标志物之间的关联，并对年龄、种族、传统CVD危险因素、肾功能、胰岛素抵抗、身体组成和脂肪分布的MRI及双能X线吸收法测量值以及左心室质量进行校正。
结果
排除患有CVD的参与者后，研究人群包括3439人，平均年龄43岁，56%为女性，52%为黑人。在多个生物标志物类别中观察到显著的性别差异，包括脂质、脂肪因子以及炎症、内皮功能障碍、心肌细胞损伤和应激以及肾功能的生物标志物。在完全校正的模型中，女性的高密度脂蛋白胆固醇和高密度脂蛋白颗粒浓度、瘦素、D-二聚体、高精氨酸和N末端B型利钠肽原水平较高，而低密度脂蛋白胆固醇、脂联素、脂蛋白相关磷脂酶A2质量和活性、单核细胞趋化蛋白-1、可溶性内皮细胞粘附分子、对称二甲基精氨酸、不对称二甲基精氨酸、高敏肌钙蛋白T和胱抑素C水平较低。
结论
普通人群中男性和女性的生物标志物谱存在显著差异。肥胖、内皮功能障碍、炎症细胞募集以及心脏应激和损伤的生物标志物的性别差异最为明显。需要进一步研究来确定这些生物标志物所描绘的病理生理过程是否导致CVD发生和并发症的性别差异。
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