Silbiger S R, Neugarten J
Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
Am J Kidney Dis. 1995 Apr;25(4):515-33. doi: 10.1016/0272-6386(95)90119-1.
Observations in experimental animals and in humans have shown that the rate of progression of renal disease is influenced by gender. Deterioration of renal function in patients with chronic renal disease is more rapid in men than in women, independent of differences in blood pressure or serum cholesterol levels. In addition to genetically determined differences between the sexes in renal structure and function, sex hormones may directly influence many of the processes implicated in the pathogenesis of renal disease progression. Potential mechanisms include receptor-mediated effects of sex hormones on glomerular hemodynamics and mesangial cell proliferation and matrix accumulation as well as effects on the synthesis and release of cytokines, vasoactive agents, and growth factors. In addition, estrogens may exert potent antioxidant actions in the mesangial microenvironment, which may contribute to the protective effect of female gender.
对实验动物和人类的观察表明，肾脏疾病的进展速度受性别影响。慢性肾病患者肾功能的恶化在男性中比在女性中更快，这与血压或血清胆固醇水平的差异无关。除了性别之间在肾脏结构和功能上由基因决定的差异外，性激素可能直接影响许多与肾病进展发病机制相关的过程。潜在机制包括性激素对肾小球血流动力学、系膜细胞增殖和基质积聚的受体介导作用，以及对细胞因子、血管活性物质和生长因子合成与释放的影响。此外，雌激素可能在系膜微环境中发挥强大的抗氧化作用，这可能有助于女性的保护作用。
