Women and lipoprotein apheresis: another side of gender medicine.

IF 3.7 3区医学 Q2 Medicine Endocrine Pub Date : 2024-12-01 Epub Date: 2024-06-28 DOI:10.1007/s12020-024-03941-x

Beatrice Dal Pino, Francesco Sbrana

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Abstract

Aim: In heterozygous Familial Hypercholesterolemia (FH) woman atherosclerotic cardiovascular disease occurs 20-years earlier respect woman without FH while homozygous FH women may suffer from atherosclerotic cardiovascular disease even in childhood. Lipoprotein apheresis, a therapeutic "last chance saloon", is a well-tolerated procedure that markedly lowers LDL-cholesterol and Lp(a) levels in patients who do not achieve acceptable levels with maximal lifestyle and drug therapy.

Methods and results: The experience of LA treatment in 3 female homozygous FH patients was described. Moreover, an explore analysis on pre and post-LA hormonal levels was performed in 8 HeFH women showing a significant improvement in the atherogenic lipid profile (total cholesterol -56%, LDL cholesterol -71%, triglycerides -72%, Apo B lipoprotein -69%, Lp(a) -59%;) and a reduction of FSH and LH values (FSH - 28%, LH -31%).

Conclusions: Women with FH experience specific barriers to care, including underrepresentation in research, significant underestimation of risk, and discontinuation of therapy during pregnancy. Therefore, in this study, we investigated the possible effects of LA treatment on plasma FSH and LH levels.

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女性与脂蛋白分离术：性别医学的另一面。

目的：在杂合子家族性高胆固醇血症（FH）妇女中，动脉粥样硬化性心血管疾病的发生要比非 FH 妇女早 20 年，而同合子 FH 妇女甚至在孩提时代就可能患有动脉粥样硬化性心血管疾病。脂蛋白清除术是一种治疗性的 "最后机会沙龙"，是一种耐受性良好的治疗方法，可显著降低通过最大限度的生活方式和药物治疗仍无法达到可接受水平的患者的低密度脂蛋白胆固醇和脂蛋白（a）水平：方法和结果：介绍了对 3 名女性同基因 FH 患者进行 LA 治疗的经验。此外，还对8名HeFH女性患者进行了LA治疗前后激素水平的探索分析，结果显示，动脉粥样硬化性血脂状况得到了显著改善（总胆固醇-56%、低密度脂蛋白胆固醇-71%、甘油三酯-72%、载脂蛋白B脂蛋白-69%、脂蛋白（a）-59%），FSH和LH值也有所下降（FSH-28%、LH-31%）：结论：患有 FH 的妇女在接受治疗时会遇到一些特殊的障碍，包括在研究中的代表性不足、风险被严重低估以及在怀孕期间停止治疗。因此，在这项研究中，我们调查了LA治疗对血浆FSH和LH水平可能产生的影响。

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

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.