Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway.
Curr Atheroscler Rep. 2023 Nov;25(11):861-868. doi: 10.1007/s11883-023-01155-6. Epub 2023 Oct 10.
This review aims to summarize the existing research on sex differences in familial hypercholesterolemia (FH) across the lifespan.
From childhood onward, total- and low-density lipoprotein cholesterol (LDL-C) levels in girls are higher than those in boys with FH. By the age of 30 years, women with FH have a higher LDL-C burden than men. In adulthood, women are diagnosed later than men, receive less lipid-lowering treatment, and consequently have higher LDL-C levels. An excessive atherosclerotic cardiovascular disease risk is reported in young female compared to male FH patients. The periods of pregnancy and breastfeeding contribute to treatment loss and increased cholesterol burden. Earlier initiation of treatment, especially in girls with FH, and lifelong treatment during all life stages are important. Future research should aim to recruit both women and men, report sex-specific data, and investigate the impact of the female life course on cardiovascular outcomes. Future guidelines should include sex-specific aspects.
本文旨在总结 FH 患者全生命周期的性别差异相关研究。
FH 患者中，从儿童期开始，女性的总胆固醇和低密度脂蛋白胆固醇（LDL-C）水平高于男性。30 岁时，女性 FH 患者的 LDL-C 负担高于男性。成年后，女性的诊断时间晚于男性，降脂治疗较少，因此 LDL-C 水平较高。年轻女性 FH 患者的动脉粥样硬化性心血管疾病风险高于男性。妊娠和哺乳期导致治疗中断和胆固醇负担增加。早期开始治疗，尤其是 FH 女孩，以及在所有生命阶段终生治疗非常重要。未来的研究应招募男女两性，报告性别特异性数据，并研究女性生命历程对心血管结局的影响。未来的指南应包含性别特异性内容。
