Key points:  A recent study showed that cardiovascular disease (CVD) biomarkers differed significantly between females and males. The results of this study may indicate pathophysiological differences in CVD progression and subsequently affect potential, gender specific, therapeutic approaches for CVD.

CVD biomarkers such as levels of lipid, endothelial function, and inflammation are used to determine individuals and populations ‘at risk’ for heart disease, heart attack, and other cardiovascular complications. However, there has been a paucity of research conducted to determine if gender affects those biomarkers and, if so, what role they might play in risk assessment and disease progression.

Dr. Jeanney Lew and her team of multicenter collaborators completed a cross-sectional analysis of over 3000 participants from the Dallas Heart Study (DHS), a cohort based population study of multiethnic Dallas County adults. Thirty biomarkers were examined in a multivariate analysis adjusting for age, race, CVD risk factors, kidney function, insulin resistance and body composition.

Results showed sex-based differences in various measurements including serum lipids, adipokine levels, and biomarkers for inflammation, endothelial dysfunction, myocyte injury and stress, and kidney function. After statistical adjustment, the researchers found women had higher levels of high-density lipoprotein (HDL) cholesterol and HDL particle concentrations and lower levels of low-density lipoprotein (LDL). Other biomarkers found to yield different results between women and men included leptin, d-dimer, adiponectin, and cystatin C to name a few.  Overall, Lew et al found many significant differences found between male and female biomarkers associated with CVD. These differences were most pronounced in biomarkers associated with endothelial function, adiposity, inflammation, and cardiac stress and injury.

This was one of the largest studies looking at differences in CVD biomarkers between males and females and substantial differences were found. However, additional research is needed to understand the relationship between these biomarkers differences, CVD pathways and progression of CVD complications. The relationship between a female’s age and menopausal status in relation to CVD also is an area of potential further investigation.

Why is this clinically relevant?

  • Gender should be considered when assessing for risks associated with various CVD biomarkers
  • Biomarker variations between men and women likely indicate pathophysiological differences in the development and complications of CVD


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