Department of Biology, McMaster University, Hamilton, Canada.
Krembil Research Institute, University Health Network and Faculty of Medicine, University of Toronto, Toronto, Canada.
J Mol Evol. 2022 Dec;90(6):401-417. doi: 10.1007/s00239-022-10072-2. Epub 2022 Sep 12.
The origins of sex-biased differences in disease and health are of growing interest to both medical researchers and health professionals. Several major factors have been identified that affect sex differences in incidence of diseases and mental disorders. These are: sex chromosomes, sex hormones and female immunity, sexual selection and antagonistic evolution, and differential susceptibility of sexes to environmental factors. These factors work on different time scales and are not exclusive of each other. Recently, a combined Sexual Selection-Sex Hormones (SS-SH) Theory was presented as an evolutionary mechanism to explain sex-biased differences in diseases and mental disorders (Singh in J Mol Evol 89:195-213, 2021). In that paper disease prevalence trends were investigated, and non-sex-specific diseases were hypothesized to be more common in males than in females in general. They showed signs of exceptions to this trend with inflammatory diseases and stress-related mental disorders that were more common in females. We believe that the SS-SH theory requires the consideration of psycho-social stress (PSS) to explain the predominance of female-biased mental disorders and some other exceptions in their findings. Here we present a theory of sex-differential experience of PSS and provide quantitative support for the combined SS-SH-PSS Theory using age-standardized incidence rates (ASIRs) recording the levels of male- and female-bias in data obtained from different countries. The grand theory provides an evolutionary framework for explaining patterns of sex-biased trends in the prevalence of disease and health. Further exploration of women's vulnerability to social factors may help to facilitate new treatments for female-biased diseases.
性别的疾病和健康差异的起源越来越引起医学研究人员和卫生专业人员的兴趣。已经确定了几个主要因素，这些因素影响疾病和精神障碍发生率的性别差异。这些因素是：性染色体、性激素和女性免疫力、性选择和拮抗进化，以及性别对环境因素的差异敏感性。这些因素作用于不同的时间尺度，并且不是相互排斥的。最近，一种结合性选择-性激素（SS-SH）理论被提出作为一种进化机制来解释疾病和精神障碍中的性别偏向差异（Singh 在 J Mol Evol 89:195-213, 2021）。在该论文中，研究了疾病流行趋势，并假设非性别特异性疾病在男性中比在女性中更为普遍。他们发现，这种趋势存在例外，炎症性疾病和与应激相关的精神障碍在女性中更为常见。我们认为，SS-SH 理论需要考虑心理社会应激（PSS）来解释女性偏倚性精神障碍的主导地位以及其研究结果中的其他一些例外情况。在这里，我们提出了一种性别的 PSS 体验差异理论，并使用记录数据中男性和女性偏差水平的年龄标准化发病率（ASIR）为 SS-SH-PSS 联合理论提供定量支持，这些数据来自不同国家。该总体理论为解释疾病和健康的性别偏向趋势的流行模式提供了一个进化框架。进一步探索女性对社会因素的脆弱性可能有助于为女性偏倚性疾病提供新的治疗方法。
