Université Paris-Saclay, Inserm, UMR-S 1180, 92296 Châtenay-Malabry, France.
Université Paris-Saclay, Inserm, UMR-S 1180, 92296 Châtenay-Malabry, France.
Biochim Biophys Acta Mol Basis Dis. 2020 Jun 1;1866(6):165722. doi: 10.1016/j.bbadis.2020.165722. Epub 2020 Feb 11.
It is increasingly recognized that sex and gender differences (S&G) influence cardiovascular diseases (CVD), greatly impacting disease management. In terms of definition, sex refers to biological aspects, gender effects being mainly related to socio-cultural factors. Both sex and gender are interpenetrated in humans and difficult to separate. This is more clearly feasible in animal models where sex effects largely predominate. As alterations in energy metabolism are essential features of cardiovascular diseases, sexual dimorphism of energy metabolism and more specifically mitochondria occupies a place of choice. This review presents the basis of sex and gender differences in the cardiovascular pathophysiology, and how it mainly affects woman diseases, effectiveness of therapies and clinical outcome. These differences rely on complex molecular mechanisms that are still poorly understood because of the under-representation of females/women in experimental and clinical studies. Finally, the differing psychological and biological phases of woman's life are largely underestimated. This review presents an overview of the field with focus on differences in cardiac energy metabolism, which are illustrated with specific examples.
越来越多的人认识到，性别差异（S&G）会影响心血管疾病（CVD），对疾病的管理产生重大影响。从定义上讲，性是指生物学方面，而性别影响主要与社会文化因素有关。性和性别在人类中相互渗透，难以分离。在动物模型中，这种情况更为明显，因为性效应在动物模型中占主导地位。由于能量代谢的改变是心血管疾病的重要特征，因此能量代谢和更具体的线粒体的性别二态性占据了重要位置。这篇综述介绍了心血管病理生理学中性别和性别差异的基础，以及它主要如何影响女性疾病、治疗效果和临床结果。这些差异依赖于复杂的分子机制，由于女性/女性在实验和临床研究中的代表性不足，这些机制仍未得到很好的理解。最后，女性生活中不同的心理和生理阶段在很大程度上被低估了。这篇综述概述了这一领域，重点介绍了心脏能量代谢方面的差异，并举例说明了这些差异。
