Department of Medicine/Division of Cardiology.
Department of Microbiology, Immunology and Molecular Genetics.
Curr Opin Lipidol. 2018 Oct;29(5):404-410. doi: 10.1097/MOL.0000000000000536.
Sex differences are pervasive in metabolic and cardiovascular traits, yet they have often been ignored in human and animal model research. Sex differences can arise from reversible hormonal effects, from irreversible organizational (developmental) processes, and from gene expression differences from the X and Y chromosomes. We briefly review our current understanding of the impact of these factors in metabolic traits and disorders, with an emphasis on the recent literature.
Novel sex differences continue to be identified for metabolic and cardiovascular traits. For example, it is now clear that gut microbiota tend to differ between men and women, with potentially large implications for disease susceptibility. Also, tissue-specific gene regulation differs between men and women, contributing to differential metabolism. These new insights will open up personalized therapeutic avenues for cardiometabolic diseases.
Sex differences in body fat distribution, glucose homeostasis, insulin signaling, ectopic fat accumulation, and lipid metabolism during normal growth and in response to hormonal or nutritional imbalance are mediated partly through sex hormones and the sex chromosome complement. Most of these differences are mediated in a tissue-specific manner. Important future goals are to better understand the interactions between genetic variation and sex differences, and to bring an understanding of sex differences into clinical practice.
代谢和心血管特征中普遍存在性别差异,但这些差异在人类和动物模型研究中经常被忽视。性别差异可能源于激素的可逆作用、不可逆的组织(发育)过程,以及来自 X 和 Y 染色体的基因表达差异。我们简要回顾了目前对这些因素在代谢特征和疾病中的影响的理解,重点是最近的文献。
新的性别差异继续被确定为代谢和心血管特征。例如,现在很清楚,肠道微生物群在男性和女性之间存在差异,这可能对疾病易感性有很大影响。此外,组织特异性基因调控在男性和女性之间存在差异,导致代谢差异。这些新的见解将为心脏代谢疾病开辟个性化的治疗途径。
在正常生长和对激素或营养失衡的反应中,体脂分布、葡萄糖稳态、胰岛素信号、异位脂肪积累和脂质代谢的性别差异部分通过性激素和性染色体组成来介导。这些差异中的大多数以组织特异性的方式介导。未来的重要目标是更好地理解遗传变异和性别差异之间的相互作用,并将性别差异的理解纳入临床实践。