Sex differences in type 2 diabetes: an opportunity for personalized medicine

IF 4.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Biology of Sex Differences Pub Date : 2023-12-13 DOI:10.1186/s13293-023-00571-2
Meredith L. Johnson, Joshua D. Preston, Cetewayo S. Rashid, Kevin J. Pearson, J. Nina Ham
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Abstract

Over the past several decades, substantial ground has been gained in understanding the biology of sex differences. With new mandates to include sex as a biological variable in NIH-funded research, greater knowledge is forthcoming on how sex chromosomes, sex hormones, and social and societal differences between sexes can affect the pathophysiology of health and disease. A detailed picture of how biological sex impacts disease pathophysiology will directly inform clinicians in their treatment approaches and challenge canonical therapeutic strategies. Thus, a profound opportunity to explore sex as a variable in personalized medicine now presents itself. While many sex differences are apparent in humans and have been described at length, we are only beginning to see how such differences impact disease progression, treatment efficacy, and outcomes in obesity, type 2 diabetes, and cardiovascular disease. Here, we briefly present the most salient and convincing evidence of sex differences in type 2 diabetes detection, diagnostics, disease course, and therapeutics. We then offer commentary on how this evidence can inform clinicians on how to approach the clinical workup and management of different patients with diabetes. Finally, we discuss some gaps that remain in the literature and propose several research questions to guide basic and translational researchers as they continue in this growing area of scientific exploration. For decades, most research in the laboratory and clinical settings focused primarily on males. However, more recently, grant-funding agencies, including the National Institutes of Health, have prioritized research that studies both males and females. This has dramatically improved our understanding of how biological sex impacts whether a person is at higher risk for developing a particular disease and what treatment options may be best to achieve the healthiest outcomes. This article offers the perspectives of practicing physicians and scientists on how our knowledge about biological sex may impact disease incidence, progression, treatment options, and outcomes in obesity, diabetes, and heart disease. The piece will offer a broad overview of the current science and personalized medicine approaches in these areas. It then discusses gaps in our knowledge and proposes several questions to guide future research.
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2 型糖尿病的性别差异:个性化医疗的机遇
过去几十年来,人们在了解性别差异的生物学方面取得了长足的进步。在美国国立卫生研究院(NIH)资助的研究中,性别作为一个生物变量被纳入了新的研究任务,人们即将获得更多关于性染色体、性激素以及社会和社会性别差异如何影响健康和疾病病理生理学的知识。详细了解生物性别如何影响疾病的病理生理学,将直接指导临床医生的治疗方法,并对传统的治疗策略提出挑战。因此,将性别作为个性化医疗中的一个变量进行探索的大好时机已经到来。虽然许多性别差异在人类身上显而易见,并且已经有了详细的描述,但我们才刚刚开始了解这些差异如何影响肥胖症、2 型糖尿病和心血管疾病的疾病进展、治疗效果和预后。在此,我们简要介绍了在 2 型糖尿病检测、诊断、病程和治疗方面性别差异最突出和最有说服力的证据。然后,我们就这些证据如何指导临床医生对不同的糖尿病患者进行临床检查和管理发表评论。最后,我们讨论了文献中仍然存在的一些空白,并提出了几个研究问题,以指导基础研究人员和转化研究人员继续在这一不断发展的科学领域进行探索。几十年来,实验室和临床环境中的大多数研究主要集中在男性身上。但最近,包括美国国立卫生研究院在内的拨款机构已将研究男性和女性的研究列为优先事项。这极大地提高了我们对生理性别如何影响一个人罹患某种疾病的风险,以及什么样的治疗方案是实现最健康结果的最佳选择的认识。本文从执业医生和科学家的角度,阐述了我们对生理性别的了解可能会如何影响肥胖症、糖尿病和心脏病的发病率、病情发展、治疗方案和治疗效果。文章将对这些领域的现有科学和个性化医疗方法进行广泛概述。然后讨论我们的知识差距,并提出几个问题以指导未来的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Biology of Sex Differences
Biology of Sex Differences ENDOCRINOLOGY & METABOLISM-GENETICS & HEREDITY
CiteScore
12.10
自引率
1.30%
发文量
69
审稿时长
14 weeks
期刊介绍: Biology of Sex Differences is a unique scientific journal focusing on sex differences in physiology, behavior, and disease from molecular to phenotypic levels, incorporating both basic and clinical research. The journal aims to enhance understanding of basic principles and facilitate the development of therapeutic and diagnostic tools specific to sex differences. As an open-access journal, it is the official publication of the Organization for the Study of Sex Differences and co-published by the Society for Women's Health Research. Topical areas include, but are not limited to sex differences in: genomics; the microbiome; epigenetics; molecular and cell biology; tissue biology; physiology; interaction of tissue systems, in any system including adipose, behavioral, cardiovascular, immune, muscular, neural, renal, and skeletal; clinical studies bearing on sex differences in disease or response to therapy.
期刊最新文献
Sex differences in the human brain related to visual motion perception. A call for inclusive research, policies, and leadership to close the global women's health gap. Sex differences in contextual fear conditioning and extinction after acute and chronic nicotine treatment. Sex dimorphism and tissue specificity of gene expression changes in aging mice. The Four Core Genotypes mouse model: evaluating the impact of a recently discovered translocation.
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