MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
BMC Med. 2021 Feb 24;19(1):58. doi: 10.1186/s12916-021-01929-2.
BACKGROUND: Males experience higher rates of coronary heart disease (CHD) than females, but the circulating traits underpinning this difference are poorly understood. We examined sex differences in systemic metabolites measured at four life stages, spanning childhood to middle adulthood. METHODS: Data were from the Avon Longitudinal Study of Parents and Children (7727 offspring, 49% male; and 6500 parents, 29% male). Proton nuclear magnetic resonance (H-NMR) spectroscopy from a targeted metabolomics platform was performed on EDTA-plasma or serum samples to quantify 229 systemic metabolites (including lipoprotein-subclass-specific lipids, pre-glycaemic factors, and inflammatory glycoprotein acetyls). Metabolites were measured in the same offspring once in childhood (mean age 8 years), twice in adolescence (16 years and 18 years) and once in early adulthood (25 years), and in their parents once in middle adulthood (50 years). Linear regression models estimated differences in metabolites for males versus females on each occasion (serial cross-sectional associations). RESULTS: At 8 years, total lipids in very-low-density lipoproteins (VLDL) were lower in males; levels were higher in males at 16 years and higher still by 18 years and 50 years (among parents) for medium-or-larger subclasses. Larger sex differences at older ages were most pronounced for VLDL triglycerides-males had 0.19 standard deviations (SD) (95% CI = 0.12, 0.26) higher at 18 years, 0.50 SD (95% CI = 0.42, 0.57) higher at 25 years, and 0.62 SD (95% CI = 0.55, 0.68) higher at 50 years. Low-density lipoprotein (LDL) cholesterol, apolipoprotein-B, and glycoprotein acetyls were generally lower in males across ages. The direction and magnitude of effects were largely unchanged when adjusting for body mass index measured at the time of metabolite assessment on each occasion. CONCLUSIONS: Our results suggest that males begin to have higher VLDL triglyceride levels in adolescence, with larger sex differences at older ages. Sex differences in other CHD-relevant metabolites, including LDL cholesterol, show the opposite pattern with age, with higher levels among females. Such life course trends may inform causal analyses with clinical endpoints in specifying traits which underpin higher age-adjusted CHD rates commonly seen among males.
背景:男性患冠心病(CHD)的比率高于女性,但造成这种差异的循环特征仍知之甚少。我们研究了在四个生命阶段测量的全身代谢物中的性别差异,这些阶段涵盖了儿童期到成年早期。
方法:数据来自阿冯纵向研究父母和孩子(7727 名后代,49%为男性;6500 名父母,29%为男性)。采用靶向代谢组学平台的质子核磁共振(H-NMR)光谱法,对 EDTA-血浆或血清样本进行定量分析,以测量 229 种全身代谢物(包括脂蛋白亚类特异性脂质、血糖前因子和炎症糖蛋白乙酰基)。在儿童期(平均年龄 8 岁)、青春期(16 岁和 18 岁)和成年早期(25 岁)各对同一批后代进行一次代谢物测量,并在其父母的中年(50 岁)进行一次代谢物测量。线性回归模型估计了每次男性与女性之间代谢物的差异(连续横断面关联)。
结果:在 8 岁时,极低密度脂蛋白(VLDL)中的总脂质在男性中较低;在 16 岁时,VLDL 中的水平在男性中较高,在 18 岁和 50 岁(在父母中)时更高,VLDL 中的中等或更大亚类的水平更高。在年龄较大时,性别差异更为明显,18 岁时男性高出 0.19 个标准差(SD)(95%CI=0.12,0.26),25 岁时高出 0.50 SD(95%CI=0.42,0.57),50 岁时高出 0.62 SD(95%CI=0.55,0.68)。在整个年龄段,男性的低密度脂蛋白(LDL)胆固醇、载脂蛋白-B 和糖蛋白乙酰基通常较低。当在每次代谢物评估时根据体重指数进行调整时,这些影响的方向和幅度基本保持不变。
结论:我们的结果表明,男性在青春期开始时就有较高的 VLDL 甘油三酯水平,随着年龄的增长,性别差异更大。其他与 CHD 相关的代谢物(包括 LDL 胆固醇)的性别差异随着年龄的增长呈现出相反的模式,女性的水平更高。这种生命过程的趋势可能为使用临床终点的因果分析提供信息,以明确导致男性中常见的年龄调整后 CHD 发病率较高的特征。
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