Gender Medicine最新文献_第9页

Age-Dependent Influence of Gender on the Association Between Obesity and a Cluster of Cardiometabolic Risk Factors 性别对肥胖和一组心脏代谢危险因素相关性的年龄依赖性影响

Gender Medicine

Pub Date : 2012-08-01 DOI: 10.1016/j.genm.2012.05.004

Ichiro Wakabayashi MD, PhD

Background

Obesity is a main risk factor in metabolic syndrome. Gender is known to influence the risk of obesity and other cardiovascular risk factors. However, it remains to be determined whether there is a gender-specific difference in the relationship between obesity and accumulation of other cardiometabolic risk factors such as hypertension, dyslipidemia, and diabetes.

Objective

The aim of this study was to determine whether the association between obesity and a cluster of other cardiometabolic risk factors is modified by gender.

Methods

The subjects were 17,791 Japanese men and women who were divided into younger (35–40 years) and older (60–70 years) age groups. The relationships between obesity (body mass index [BMI] ≥25 kg/m² or waist-to-height ratio [WHtR] ≥0.5) and multiple cardiometabolic risk factors (≥2 of the risk factors of high blood pressure, dyslipidema, and hyperglycemia) were compared between men and women in each age group.

Results

In the younger group, the crude odds ratios (ORs) for multiple cardiometabolic risk factors in obese versus nonobese subjects were significantly higher in women than in men (BMI: 6.23 [range, 5.53–7.02] in men vs 16.63 [range, 12.37–22.37] in women, P < 0.01; WHtR: 6.04 [range, 5.36–6.81] in men vs 9.77 [range, 7.14–13.37] in women, P < 0.01), whereas this difference was not found in the older group (BMI: 3.03 [range, 2.69–3.42] in men vs 2.92 [range, 2.33–3.67] in women P = 0.076; WHtR: 3.11 [range, 2.78–3.47] in men vs 2.50 [range, 2.02–3.09] in women, P < 0.05). On multivariate logistic regression analysis, the ORs for multiple cardiometabolic risk factors after adjusting for age, smoking, alcohol consumption, and regular exercise in subjects with versus subjects without a large waist circumference tended to be higher in women than in men in the younger group but not in the older group. The ORs of the interaction term consisting of gender and each adiposity index for multiple cardiometabolic risk factors were significantly higher than a reference level of 1.00 in the younger group (BMI: 2.68 [range, 1.95–3.69], P < 0.01; WHtR: 1.62 [range, 1.16–2.27], P < 0.01) but not in the older group (BMI: 0.95 [range, 0.74–1.23], P = 0.712; WHtR: 0.80 [range, 0.63–1.02], P = 0.066).

Conclusion

The results suggest that the association between obesity and a cluster of cardiometabolic risk factors is stronger in women than in men, and this gender-specific difference exists in younger (35–40 years) but not in older (60–70 years) individuals.

背景:肥胖是代谢综合征的主要危险因素。众所周知，性别会影响肥胖和其他心血管风险因素的风险。然而，肥胖与其他心脏代谢危险因素(如高血压、血脂异常和糖尿病)积累之间的关系是否存在性别差异仍有待确定。目的本研究的目的是确定肥胖和其他一系列心脏代谢危险因素之间的关联是否受性别的影响。方法研究对象为17791名日本男性和女性，分为年轻组(35-40岁)和老年组(60-70岁)。比较各年龄组男女肥胖(体重指数[BMI]≥25kg /m2或腰高比[WHtR]≥0.5)与多种心脏代谢危险因素(高血压、血脂异常水肿、高血糖危险因素≥2个)之间的关系。结果在年轻组中，女性肥胖与非肥胖受试者的多种心脏代谢危险因素的粗比值比(or)显著高于男性(BMI:男性6.23[范围，5.53-7.02]，女性16.63[范围，12.37-22.37]，P <0.01;WHtR:男性6.04[范围，5.36-6.81]，女性9.77[范围，7.14-13.37]，P <0.01)，而在老年组中没有发现这种差异(男性BMI: 3.03[范围，2.69-3.42]vs女性BMI: 2.92[范围，2.33-3.67]P = 0.076;WHtR:男性3.11[范围，2.78-3.47]，女性2.50[范围，2.02-3.09]，P <0.05)。在多变量logistic回归分析中，在调整了年龄、吸烟、饮酒和定期运动等因素后，女性与非大腰围受试者的ORs在年轻组中往往高于男性，而在老年组中则没有。由性别和各肥胖指数组成的多重心脏代谢危险因素交互项的or值在年轻组显著高于参考水平1.00 (BMI: 2.68[范围，1.95-3.69]，P <0.01;WHtR: 1.62[区间，1.16-2.27]，P <0.01)，但老年组无差异(BMI: 0.95[范围，0.74-1.23]，P = 0.712;WHtR: 0.80[范围，0.63-1.02]，P = 0.066)。结论肥胖与一系列心脏代谢危险因素之间的相关性在女性中强于男性，这种性别差异存在于年轻人(35-40岁)中，而不存在于老年人(60-70岁)中。

{"title":"Age-Dependent Influence of Gender on the Association Between Obesity and a Cluster of Cardiometabolic Risk Factors","authors":"Ichiro Wakabayashi MD, PhD","doi":"10.1016/j.genm.2012.05.004","DOIUrl":"10.1016/j.genm.2012.05.004","url":null,"abstract":"<div><h3>Background</h3><p>Obesity is a main risk factor in metabolic syndrome<span><span>. Gender is known to influence the risk of obesity and other cardiovascular risk factors. However, it remains to be determined whether there is a gender-specific difference in the relationship between obesity and accumulation of other cardiometabolic risk factors such as hypertension, </span>dyslipidemia, and diabetes.</span></p></div><div><h3>Objective</h3><p>The aim of this study was to determine whether the association between obesity and a cluster of other cardiometabolic risk factors is modified by gender.</p></div><div><h3>Methods</h3><p>The subjects were 17,791 Japanese men and women who were divided into younger (35–40 years) and older (60–70 years) age groups. The relationships between obesity (body mass index [BMI] ≥25 kg/m<sup>2</sup> or waist-to-height ratio [WHtR] ≥0.5) and multiple cardiometabolic risk factors (≥2 of the risk factors of high blood pressure, dyslipidema, and hyperglycemia) were compared between men and women in each age group.</p></div><div><h3>Results</h3><p>In the younger group, the crude odds ratios (ORs) for multiple cardiometabolic risk factors in obese versus nonobese subjects were significantly higher in women than in men (BMI: 6.23 [range, 5.53–7.02] in men vs 16.63 [range, 12.37–22.37] in women, <em>P</em> < 0.01; WHtR: 6.04 [range, 5.36–6.81] in men vs 9.77 [range, 7.14–13.37] in women, <em>P</em> < 0.01), whereas this difference was not found in the older group (BMI: 3.03 [range, 2.69–3.42] in men vs 2.92 [range, 2.33–3.67] in women <em>P</em> = 0.076; WHtR: 3.11 [range, 2.78–3.47] in men vs 2.50 [range, 2.02–3.09] in women, <em>P</em><span> < 0.05). On multivariate logistic regression analysis, the ORs for multiple cardiometabolic risk factors after adjusting for age, smoking, alcohol consumption, and regular exercise in subjects with versus subjects without a large waist circumference tended to be higher in women than in men in the younger group but not in the older group. The ORs of the interaction term consisting of gender and each adiposity index for multiple cardiometabolic risk factors were significantly higher than a reference level of 1.00 in the younger group (BMI: 2.68 [range, 1.95–3.69], </span><em>P</em> < 0.01; WHtR: 1.62 [range, 1.16–2.27], <em>P</em> < 0.01) but not in the older group (BMI: 0.95 [range, 0.74–1.23], <em>P</em> = 0.712; WHtR: 0.80 [range, 0.63–1.02], <em>P</em> = 0.066).</p></div><div><h3>Conclusion</h3><p>The results suggest that the association between obesity and a cluster of cardiometabolic risk factors is stronger in women than in men, and this gender-specific difference exists in younger (35–40 years) but not in older (60–70 years) individuals.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 4","pages":"Pages 267-277"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30729577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 31

Sex Differences in Lung Gas Volumes After Lipopolysaccharide-Induced Chorioamnionitis in Fetal Sheep 脂多糖诱导胎羊绒毛膜羊膜炎后肺气量的性别差异

Gender Medicine

Pub Date : 2012-08-01 DOI: 10.1016/j.genm.2012.05.005

Verena A.C. Lambermont MSc , Jasper V. Been MD, MPH, PhD , Steffen Kunzmann MD , Sizzle F. Vanterpool BSc , John P. Newnham MD , Suhas G. Kallapur MD , Alan H. Jobe MD, PhD , Boris W. Kramer MD, PhD

Background

Preterm female infants have a survival advantage and enhanced lung development, which is an important determinant of preterm survival.

Objective

Given the modulation of lung development by fetal exposure to infection/inflammation, we hypothesized that female fetuses have enhanced lung maturational responses to chorioamnionitis compared with male fetuses.

Methods

Time-pregnant ewes received intra-amniotic injections with saline (n = 60) or lipopolysaccharide (LPS) at 2 days (n = 30) or 7 days (n = 45) before surgical delivery at 123 to 125 days of gestation (term: ∼147 days). We assessed inflammatory responses in bronchoalveolar lavage fluid and cord blood, lung maturation with pressure-volume curves, and lung structure.

Results

Lung gas volume showed differences between the sexes after 2 days LPS (male 4.6 [1.2] mL/kg, female 7.7 [4.4] mL/kg; P = 0.02) and 7 days LPS (male 20.5 [9.3] mL/kg, female 27.0 [7.0] mL/kg; P = 0.01). The control group was not different by sex (male 8.0 [3.6] mL/kg, female 8.9 [3.9] mL/kg; P > 0.05). No difference in lung structure and in pulmonary and systemic inflammatory response was evident by sex.

Conclusion

Preterm female sheep fetuses had increased lung gas volumes after exposure to LPS, without any detectable differences in fetal inflammatory responses.

背景早产女婴具有生存优势，肺部发育增强，这是早产存活率的重要决定因素。目的考虑到胎儿暴露于感染/炎症对肺发育的调节，我们假设与男性胎儿相比，女性胎儿对绒毛膜羊膜炎的肺成熟反应更强。方法在妊娠123 ~ 125天(妊娠期:~ 147天)分娩前2天(n = 30)或7天(n = 45)，对妊娠期母羊进行羊膜内注射生理盐水(n = 60)或脂多糖(LPS)。我们评估了支气管肺泡灌洗液和脐带血的炎症反应，肺成熟的压力-体积曲线和肺结构。结果LPS作用后2 d的肺气量存在性别差异(男性4.6 [1.2]mL/kg，女性7.7 [4.4]mL/kg;P = 0.02)和7 d LPS(男性20.5 [9.3]mL/kg，女性27.0 [7.0]mL/kg;P = 0.01)。对照组性别差异无统计学意义(男性8.0 [3.6]mL/kg，女性8.9 [3.9]mL/kg;P比;0.05)。肺结构、肺部和全身炎症反应无明显性别差异。结论暴露于LPS后，早产母羊胎儿肺气量增加，但胎儿炎症反应无明显差异。

{"title":"Sex Differences in Lung Gas Volumes After Lipopolysaccharide-Induced Chorioamnionitis in Fetal Sheep","authors":"Verena A.C. Lambermont MSc , Jasper V. Been MD, MPH, PhD , Steffen Kunzmann MD , Sizzle F. Vanterpool BSc , John P. Newnham MD , Suhas G. Kallapur MD , Alan H. Jobe MD, PhD , Boris W. Kramer MD, PhD","doi":"10.1016/j.genm.2012.05.005","DOIUrl":"10.1016/j.genm.2012.05.005","url":null,"abstract":"<div><h3>Background</h3><p>Preterm female infants have a survival advantage and enhanced lung development, which is an important determinant of preterm survival.</p></div><div><h3>Objective</h3><p>Given the modulation of lung development by fetal exposure to infection/inflammation, we hypothesized that female fetuses have enhanced lung maturational responses to chorioamnionitis compared with male fetuses.</p></div><div><h3>Methods</h3><p><span>Time-pregnant ewes received intra-amniotic injections with saline (n = 60) or lipopolysaccharide (LPS) at 2 days (n = 30) or 7 days (n = 45) before </span>surgical delivery<span><span> at 123 to 125 days of gestation (term: ∼147 days). We assessed inflammatory responses in bronchoalveolar lavage fluid and cord blood, </span>lung maturation with pressure-volume curves, and lung structure.</span></p></div><div><h3>Results</h3><p>Lung gas volume showed differences between the sexes after 2 days LPS (male 4.6 [1.2] mL/kg, female 7.7 [4.4] mL/kg; <em>P</em> = 0.02) and 7 days LPS (male 20.5 [9.3] mL/kg, female 27.0 [7.0] mL/kg; <em>P</em> = 0.01). The control group was not different by sex (male 8.0 [3.6] mL/kg, female 8.9 [3.9] mL/kg; <em>P</em> > 0.05). No difference in lung structure and in pulmonary and systemic inflammatory response was evident by sex.</p></div><div><h3>Conclusion</h3><p>Preterm female sheep fetuses had increased lung gas volumes after exposure to LPS, without any detectable differences in fetal inflammatory responses.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 4","pages":"Pages 278-286"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30738698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Challenges of Work–Life Balance for Women Physicians/Mothers Working in Leadership Positions 担任领导职务的女医生/母亲工作与生活平衡的挑战

Gender Medicine

Pub Date : 2012-08-01 DOI: 10.1016/j.genm.2012.04.002

Claudia Schueller-Weidekamm MD, MBA , Alexandra Kautzky-Willer MD

Background

Female leadership in medicine is still disproportionately small, which might be due to the barriers of combining work and family.

Objectives

The aim of this study was, first, to perform a strengths, weakness, opportunities, and threats (SWOT) analysis and, second, to create a strategic concept for career development.

Methods

In this study, all women in leadership positions in the health care system in Vienna, Austria, with at least 1 child (n = 8), were interviewed about the advantages and disadvantages of gender with regard to career development, the strengths and weaknesses of female leadership, and their work–life balance. Different factors that influenced the work–life balance were specified, and career strategies to realize adequate solutions were developed.

Results

The sporadic focus on career advancement, time-consuming child care, responsibility for family life, and a woman's tendency toward understatement were barriers to career development. Work–family enrichment has a positive spillover effect that spreads positive energy and helps to balance the work–life relationship. For each individual, the allocation and interaction of different resources such as time, money, scope of decision making, and physical, emotional, and social resources, were essential to maintain the individual work–life balance.

Conclusions

In addition to the existing “glass ceiling,” the predominant responsibility for child care is still borne by the woman. However, mentoring programs, coaching, networking, and support of the partner or of other people help to strengthen female “soft” skills and achieve a work–life balance.

医学领域的女性领导者仍然少得不成比例，这可能是由于工作和家庭结合的障碍。本研究的目的是，首先，执行一个优势，劣势，机会和威胁(SWOT)分析，其次，创建一个职业发展的战略概念。方法在本研究中，对奥地利维也纳所有在卫生保健系统中担任领导职务的女性(至少有1个孩子)(n = 8)进行了访谈，了解性别在职业发展方面的优势和劣势、女性领导的优势和劣势以及她们的工作与生活平衡。指出了影响工作与生活平衡的不同因素，并制定了实现适当解决方案的职业策略。结果:对职业发展的零星关注、耗时的照顾孩子、家庭生活的责任以及女性倾向于低调是职业发展的障碍。工作家庭充实具有积极的溢出效应，传播正能量，有助于平衡工作生活关系。对于每个人来说，不同资源的分配和相互作用，如时间、金钱、决策范围、身体、情感和社会资源，对于维持个人的工作与生活平衡至关重要。结论除了现有的“玻璃天花板”外，照顾孩子的主要责任仍然由女性承担。然而，指导项目、指导、人际网络以及伴侣或其他人的支持有助于增强女性的“软”技能，实现工作与生活的平衡。

{"title":"Challenges of Work–Life Balance for Women Physicians/Mothers Working in Leadership Positions","authors":"Claudia Schueller-Weidekamm MD, MBA , Alexandra Kautzky-Willer MD","doi":"10.1016/j.genm.2012.04.002","DOIUrl":"10.1016/j.genm.2012.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Female leadership in medicine is still disproportionately small, which might be due to the barriers of combining work and family.</p></div><div><h3>Objectives</h3><p>The aim of this study was, first, to perform a strengths, weakness, opportunities, and threats (SWOT) analysis and, second, to create a strategic concept for career development.</p></div><div><h3>Methods</h3><p>In this study, all women in leadership positions in the health care system in Vienna, Austria, with at least 1 child (n = 8), were interviewed about the advantages and disadvantages of gender with regard to career development, the strengths and weaknesses of female leadership, and their work–life balance. Different factors that influenced the work–life balance were specified, and career strategies to realize adequate solutions were developed.</p></div><div><h3>Results</h3><p>The sporadic focus on career advancement, time-consuming child care, responsibility for family life, and a woman's tendency toward understatement were barriers to career development. Work–family enrichment has a positive spillover effect that spreads positive energy and helps to balance the work–life relationship. For each individual, the allocation and interaction of different resources such as time, money, scope of decision making, and physical, emotional, and social resources, were essential to maintain the individual work–life balance.</p></div><div><h3>Conclusions</h3><p>In addition to the existing “glass ceiling,” the predominant responsibility for child care is still borne by the woman. However, mentoring programs, coaching, networking, and support of the partner or of other people help to strengthen female “soft” skills and achieve a work–life balance.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 4","pages":"Pages 244-250"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30642658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 108

The authors respond 作者回应道

Gender Medicine

Pub Date : 2012-08-01 DOI: 10.1016/j.genm.2012.06.004

Kymberlee Montgomery DrNP, WHNP-BC, CNE, MaryEllen Glasgow PhD, RN, ACNS-BC, Anand Bhattacharya MHS

引用次数: 0

Testosterone Levels and Androgen Receptor Gene Polymorphism Predict Specific Symptoms of Depression in Young Men 睾丸激素水平和雄激素受体基因多态性预测年轻男性抑郁症的特定症状

Gender Medicine

Pub Date : 2012-08-01 DOI: 10.1016/j.genm.2012.05.001

Janani S. Sankar MSc , Elizabeth Hampson PhD

Background

Testosterone (T) has been hypothesized to modulate the expression of depressive symptoms in men; however, support for this proposition is mixed.

Objective

To investigate bioavailable T, measured from saliva, and androgen receptor gene (AR) polymorphism (the number of glutamine [CAG] repeats in exon 1 of AR) and their relation to discrete symptoms of depression in 150 men aged 17 to 27 years who varied in mood status from depressed to nondepressed.

Methods

Participants completed the Center for Epidemiologic Studies Depression Scale and the Patient Health Questionnaire-9. Principal components analysis of the scales identified 5 factors: Negative Affect, Social/Evaluative, Cognitive, Sleep, and Appetite.

Results

Across the sample as a whole, higher ratings on sleep symptoms of depression were predicted by lower T concentrations and shorter CAG lengths. The association between T, CAG length, and sleep symptoms was confirmed among the subgroup of men who reported moderate to severe depression. In this subgroup, CAG repeats and T concentrations also emerged as significant predictors of negative affect scores, with the number of CAG repeats making the primary contribution.

Conclusions

These findings suggest that androgens may influence specific symptoms of depression in men.

背景:睾酮(T)已被假设可以调节男性抑郁症状的表达;然而，对这一主张的支持褒贬不一。目的研究150名17 ~ 27岁男性抑郁和非抑郁情绪状态的唾液生物利用度T和雄激素受体基因(AR)多态性(AR外显子1中谷氨酰胺重复数)及其与离散抑郁症状的关系。方法完成美国流行病学研究中心抑郁量表和患者健康问卷-9。主成分分析量表确定了5个因素:负面影响，社会/评估，认知，睡眠和食欲。结果在整个样本中，较低的T浓度和较短的CAG长度预测了抑郁症睡眠症状的较高评分。在报告中度至重度抑郁症的男性亚组中，T、CAG长度和睡眠症状之间的关联得到了证实。在这个亚组中，CAG重复序列和T浓度也成为负面情绪评分的重要预测因子，其中CAG重复序列的数量是主要因素。结论这些发现提示雄激素可能影响男性抑郁症的特定症状。

{"title":"Testosterone Levels and Androgen Receptor Gene Polymorphism Predict Specific Symptoms of Depression in Young Men","authors":"Janani S. Sankar MSc , Elizabeth Hampson PhD","doi":"10.1016/j.genm.2012.05.001","DOIUrl":"10.1016/j.genm.2012.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Testosterone (T) has been hypothesized to modulate the expression of depressive symptoms in men; however, support for this proposition is mixed.</p></div><div><h3>Objective</h3><p><span>To investigate bioavailable T, measured from saliva, and androgen receptor gene (</span><em>AR</em>) polymorphism (the number of glutamine [CAG] repeats in exon 1 of <em>AR</em>) and their relation to discrete symptoms of depression in 150 men aged 17 to 27 years who varied in mood status from depressed to nondepressed.</p></div><div><h3>Methods</h3><p>Participants completed the Center for Epidemiologic Studies Depression Scale and the Patient Health Questionnaire-9. Principal components analysis of the scales identified 5 factors: Negative Affect, Social/Evaluative, Cognitive, Sleep, and Appetite.</p></div><div><h3>Results</h3><p>Across the sample as a whole, higher ratings on sleep symptoms of depression were predicted by lower T concentrations and shorter CAG lengths. The association between T, CAG length, and sleep symptoms was confirmed among the subgroup of men who reported moderate to severe depression. In this subgroup, CAG repeats and T concentrations also emerged as significant predictors of negative affect scores, with the number of CAG repeats making the primary contribution.</p></div><div><h3>Conclusions</h3><p>These findings suggest that androgens may influence specific symptoms of depression in men.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 4","pages":"Pages 232-243"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30714252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Agonistic Autoantibodies to the Angiotensin II Type I Receptor Cause Pathophysiologic Characteristics of Preeclampsia 血管紧张素II型受体的激动性自身抗体引起子痫前期的病理生理特征

Gender Medicine

Pub Date : 2012-06-01 DOI: 10.1016/j.genm.2012.03.001

Babbette LaMarca PhD, Marc R. Parrish DO, Kedra Wallace PhD

Background

Preeclampsia (PE), new-onset hypertension with proteinuria during pregnancy, is associated with increased reactive oxygen species, the vasoactive peptide endothelin-1 (ET-1), T and B lymphocytes, soluble antiangiogenic factors sFlt-1 and sEndoglin (sFlt-1 and sEng), and agonistic autoantibodies to the angiotensin II type I receptor (AT1-AA).

Objectives

One important area of investigation for our laboratory was to determine what role AT1-AA plays in the pathophysiology associated with PE.

Methods

To achieve this goal, we examined the effect of AT1-AA suppression on hypertension in response to placental ischemia as well as the effect of AT1-AA on increased blood pressure, ET-1, reactive oxygen species, and sFlt-1 in normal pregnant rats (NP).

Results

We demonstrated reductions in uterine perfusion pressure (RUPP) to be a stimulus for AT1-AA during pregnancy. We utilized the technique of B-cell depletion to suppress circulating AT1-AA in RUPP rats and found that AT1-AA suppression in RUPP rats was associated with lower blood pressure and ET-1 activation. To determine a role for AT1-AA to mediate hypertension during pregnancy, we infused purified rat AT1-AA (1:50) into NP rats, and analyzed blood pressure and soluble factors. We consistently found that AT1-AA infused rats had significantly increased AT1-AA and blood pressure above NP rats. This hypertension was associated with significantly increased ET-1 in renal cortices (11-fold) and placenta (4-fold), and there was an approximately 2- to 3-fold increase in placental oxidative stress. Furthermore, antiangiogenic factors sFlt-1 and sEng were significantly increased in the AT1-AA induced hypertensive group compared with the NP controls.

Conclusions

Collectively, these data indicated an important role for AT1-AA stimulated in response to placental ischemia that caused hypertension during pregnancy.

背景子痫前期(PE)，妊娠期新发高血压伴蛋白尿，与活性氧、血管活性肽内皮素-1 (ET-1)、T淋巴细胞和B淋巴细胞、可溶性抗血管生成因子sFlt-1和sEndoglin (sFlt-1和sEng)以及血管紧张素II型受体(AT1-AA)的激动性自身抗体升高有关。目的我们实验室的一个重要研究领域是确定AT1-AA在PE相关的病理生理中所起的作用。方法观察AT1-AA对胎盘缺血大鼠高血压的抑制作用，以及AT1-AA对正常妊娠大鼠(NP)血压、ET-1、活性氧和sFlt-1升高的影响。结果子宫灌注压(RUPP)的降低是妊娠期间AT1-AA的刺激因素。我们利用b细胞耗尽技术抑制RUPP大鼠循环AT1-AA，发现RUPP大鼠AT1-AA抑制与降低血压和ET-1激活有关。为了确定AT1-AA在妊娠期介导高血压的作用，我们将纯化的大鼠AT1-AA(1:50)注入NP大鼠体内，分析血压和可溶性因子。我们一致发现，注射AT1-AA的大鼠的AT1-AA和血压明显高于NP大鼠。高血压与肾皮质ET-1(11倍)和胎盘ET-1(4倍)显著增加有关，胎盘氧化应激增加约2- 3倍。此外，与NP对照组相比，AT1-AA诱导的高血压组抗血管生成因子sFlt-1和sEng显著升高。综上所述，这些数据表明AT1-AA在妊娠期胎盘缺血引起的高血压反应中发挥了重要作用。

{"title":"Agonistic Autoantibodies to the Angiotensin II Type I Receptor Cause Pathophysiologic Characteristics of Preeclampsia","authors":"Babbette LaMarca PhD, Marc R. Parrish DO, Kedra Wallace PhD","doi":"10.1016/j.genm.2012.03.001","DOIUrl":"10.1016/j.genm.2012.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Preeclampsia (PE), new-onset hypertension with proteinuria during pregnancy, is associated with increased reactive oxygen species, the vasoactive peptide endothelin-1 (ET-1), T and B lymphocytes, soluble antiangiogenic factors sFlt-1 and sEndoglin (sFlt-1 and sEng), and agonistic autoantibodies to the angiotensin II type I receptor (AT1-AA).</p></div><div><h3>Objectives</h3><p>One important area of investigation for our laboratory was to determine what role AT1-AA plays in the pathophysiology associated with PE.</p></div><div><h3>Methods</h3><p>To achieve this goal, we examined the effect of AT1-AA suppression on hypertension in response to placental ischemia as well as the effect of AT1-AA on increased blood pressure, ET-1, reactive oxygen species, and sFlt-1 in normal pregnant rats (NP).</p></div><div><h3>Results</h3><p>We demonstrated reductions in uterine perfusion pressure (RUPP) to be a stimulus for AT1-AA during pregnancy. We utilized the technique of B-cell depletion to suppress circulating AT1-AA in RUPP rats and found that AT1-AA suppression in RUPP rats was associated with lower blood pressure and ET-1 activation. To determine a role for AT1-AA to mediate hypertension during pregnancy, we infused purified rat AT1-AA (1:50) into NP rats, and analyzed blood pressure and soluble factors. We consistently found that AT1-AA infused rats had significantly increased AT1-AA and blood pressure above NP rats. This hypertension was associated with significantly increased ET-1 in renal cortices (11-fold) and placenta (4-fold), and there was an approximately 2- to 3-fold increase in placental oxidative stress. Furthermore, antiangiogenic factors sFlt-1 and sEng were significantly increased in the AT1-AA induced hypertensive group compared with the NP controls.</p></div><div><h3>Conclusions</h3><p>Collectively, these data indicated an important role for AT1-AA stimulated in response to placental ischemia that caused hypertension during pregnancy.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 3","pages":"Pages 139-146"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30571441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 47

Age-Dependent Reductions in Mitochondrial Respiration are Exacerbated by Calcium in the Female Rat Heart 在雌性大鼠心脏中，钙加剧了年龄依赖性线粒体呼吸减少

Gender Medicine

Pub Date : 2012-06-01 DOI: 10.1016/j.genm.2012.04.001

J. Craig Hunter PhD , Alexandra M. Machikas BS , Donna H. Korzick PhD

Background

Cardiovascular disease mortality increases rapidly after menopause by poorly defined mechanisms.

Objective

Because mitochondrial function and Ca²⁺ sensitivity are important regulators of cell death after myocardial ischemia, we sought to determine whether aging and/or estrogen deficiency (ovariectomy) increased mitochondrial Ca²⁺ sensitivity.

Methods

Mitochondrial respiration was measured in ventricular mitochondria isolated from adult (6 months; n = 26) and aged (24 months; n = 25), intact or ovariectomized female rats using the substrates α-ketoglutarate/malate (complex I); succinate/rotenone (complex II); ascorbate/N,N,N′,N′-tetramethyl-p-phenylenediamine/antimycin (complex IV). State 2 and 3 respiration was initiated by sequential addition of mitochondria and adenosine diphosphate. Ca²⁺ sensitivity was assessed by Ca²⁺-induced swelling of de-energized mitochondria and reduction in state 3 respiration. Propylpyrazole triol (PPT) was administered intraperitoneally 45 minutes before euthanasia to assess mitochondrial protective effects through estrogen receptor (ER) α activation.

Results

Aging decreased the respiratory control index (RCI; state 3/state 2) for complexes I and II by 12% and 8%, respectively, independent of ovary status (P < 0.05). Of interest, Ca²⁺ induced a greater decrease (18%–30%; P < 0.05) in complex I state 3 respiration in aged and ovariectomized animals, and mitochondrial swelling occurred twice as quickly in aged (vs adult) female rats (P < 0.05). Pretreatment with PPT increased RCI by 8% and 7% at complexes I and II, respectively (P < 0.05) but surprisingly increased Ca²⁺ sensitivity.

Conclusions

Age-dependent decreases in RCI and sensitization to Ca²⁺ may explain in part the age-associated reductions in female ischemic tolerance; however, protection afforded by ER agonism involves more complex mechanisms.

背景:绝经后心血管疾病死亡率迅速增加，机制不明确。由于线粒体功能和Ca2+敏感性是心肌缺血后细胞死亡的重要调节因子，我们试图确定衰老和/或雌激素缺乏(卵巢切除术)是否会增加线粒体Ca2+敏感性。方法对成人(6月龄;N = 26)和年龄(24个月;n = 25)，使用底物α-酮戊二酸酯/苹果酸酯(复合物I)的完整或切除卵巢的雌性大鼠;琥珀酸盐/鱼藤酮(配合物II);抗坏血酸/N,N,N '，N ' -四甲基-对苯二胺/抗霉素(络合物IV)。状态2和3呼吸通过线粒体和二磷酸腺苷的顺序添加而启动。通过Ca2+诱导的去能量线粒体肿胀和状态3呼吸减少来评估Ca2+敏感性。安乐死前45分钟腹腔注射丙基吡唑三醇(PPT)，通过激活雌激素受体(ER) α评估其线粒体保护作用。结果衰老降低呼吸控制指数(RCI);状态3/状态2)复合物I和II分别增加12%和8%，与卵巢状态无关(P <0.05)。有趣的是，Ca2+诱导了更大的下降(18%-30%;P & lt;0.05)，老龄和去卵巢大鼠在复合体I状态3呼吸中发生线粒体肿胀的速度是成年雌性大鼠的两倍(P <0.05)。PPT预处理使配合物I和II的RCI分别提高8%和7% (P <0.05)，但出人意料地增加了Ca2+敏感性。结论RCI的年龄依赖性下降和Ca2+敏化可能部分解释了女性缺血耐受性的年龄相关性降低;然而，内质网激动作用提供的保护涉及更复杂的机制。

{"title":"Age-Dependent Reductions in Mitochondrial Respiration are Exacerbated by Calcium in the Female Rat Heart","authors":"J. Craig Hunter PhD , Alexandra M. Machikas BS , Donna H. Korzick PhD","doi":"10.1016/j.genm.2012.04.001","DOIUrl":"10.1016/j.genm.2012.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disease mortality increases rapidly after menopause by poorly defined mechanisms.</p></div><div><h3>Objective</h3><p>Because mitochondrial function and Ca<sup>2+</sup><span><span> sensitivity are important regulators of cell death after </span>myocardial ischemia<span>, we sought to determine whether aging and/or estrogen deficiency (ovariectomy) increased mitochondrial Ca</span></span><sup>2+</sup> sensitivity.</p></div><div><h3>Methods</h3><p><span>Mitochondrial respiration was measured in ventricular mitochondria isolated from adult (6 months; n = 26) and aged (24 months; n = 25), intact or ovariectomized female rats using the substrates α-ketoglutarate/malate (complex I); succinate/rotenone (complex II); ascorbate/</span><em>N</em>,<em>N</em>,<em>N</em>′,<em>N</em>′-tetramethyl-p-phenylenediamine/antimycin (complex IV). State 2 and 3 respiration was initiated by sequential addition of mitochondria and adenosine diphosphate. Ca<sup>2+</sup> sensitivity was assessed by Ca<sup>2+</sup><span>-induced swelling of de-energized mitochondria and reduction in state 3 respiration. Propylpyrazole triol (PPT) was administered intraperitoneally 45 minutes before euthanasia to assess mitochondrial protective effects through estrogen receptor (ER) α activation.</span></p></div><div><h3>Results</h3><p><span>Aging decreased the respiratory control index (RCI; state 3/state 2) for complexes I and II by 12% and 8%, respectively, independent of ovary status (</span><em>P</em> < 0.05). Of interest, Ca<sup>2+</sup> induced a greater decrease (18%–30%; <em>P</em><span> < 0.05) in complex I state 3 respiration in aged and ovariectomized animals, and mitochondrial swelling occurred twice as quickly in aged (vs adult) female rats (</span><em>P</em> < 0.05). Pretreatment with PPT increased RCI by 8% and 7% at complexes I and II, respectively (<em>P</em> < 0.05) but surprisingly increased Ca<sup>2+</sup> sensitivity.</p></div><div><h3>Conclusions</h3><p>Age-dependent decreases in RCI and sensitization to Ca<sup>2+</sup><span> may explain in part the age-associated reductions in female ischemic tolerance; however, protection afforded by ER agonism involves more complex mechanisms.</span></p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 3","pages":"Pages 197-206"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30592491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Sex-Dependent Programming of Glucose and Fatty Acid Metabolism in Mouse Offspring by Maternal Protein Restriction 通过母体蛋白限制小鼠后代葡萄糖和脂肪酸代谢的性别依赖性编程

Gender Medicine

Pub Date : 2012-06-01 DOI: 10.1016/j.genm.2012.01.004

Esther M.E. van Straten PhD , Vincent W. Bloks , Theo H. van Dijk PhD , Julius F.W. Baller , Nicolette C.A. Huijkman , Irma Kuipers PhD , Henkjan J. Verkade MD, PhD , Torsten Plösch PhD

Background

Nutritional conditions during fetal life influence the risk of the development of metabolic syndrome and cardiovascular diseases in adult life (metabolic programming). Impaired glucose tolerance and dysregulated fatty acid metabolism are hallmarks of metabolic syndrome.

Objective

We aimed to establish a mouse model of metabolic programming focusing on the sex-specific effects of a maternal low-protein diet during gestation on glucose and lipid metabolism in the adult offspring.

Methods

Pregnant C57BL/6 mice received a control or a low-protein diet (18% vs 9% casein) throughout gestation. Male and female offspring received a low-fat or a high-fat diet from 6 to 22 weeks of age.

Results

Maternal low-protein diet during gestation led to deteriorated insulin sensitivity on high-fat feeding in female offspring, as determined by biochemical and microarray analyses. Female offspring of control diet–fed dams were relatively resistant to high-fat diet–induced metabolic dysregulation. In contrast, maternal low-protein diet did not specifically affect the metabolic parameters addressed in male offspring. In males, the high-fat diet led to insulin insensitivity regardless of the diet of the dam.

Conclusions

Our findings show that fetal malnutrition has a limited impact on male mouse offspring, yet it does influence the metabolic response to a high-fat diet in females. These findings may have implications for future early diagnostics in metabolic syndrome and for the development of sex-specific treatment regimens.

胎儿时期的营养状况会影响成年后代谢综合征和心血管疾病的发生风险(代谢规划)。糖耐量受损和脂肪酸代谢失调是代谢综合征的标志。目的建立小鼠代谢编程模型，研究母体妊娠期低蛋白饮食对成年后代糖脂代谢的性别特异性影响。方法妊娠期C57BL/6小鼠分别饲喂对照组和低蛋白饲粮(酪蛋白18% vs 9%)。从6周龄到22周龄，雄性和雌性后代分别接受低脂或高脂饮食。结果通过生化和芯片分析发现，妊娠期母体低蛋白饮食导致雌性后代对高脂肪喂养的胰岛素敏感性下降。对照饲料喂养的雌性后代相对抵抗高脂肪饮食引起的代谢失调。相比之下，母体低蛋白饮食并没有特别影响雄性后代的代谢参数。在雄性中，高脂肪饮食导致胰岛素不敏感，而与雌性的饮食无关。结论胎儿营养不良对雄性小鼠后代的影响有限，但会影响雌性小鼠对高脂肪饮食的代谢反应。这些发现可能对未来代谢综合征的早期诊断和性别特异性治疗方案的发展具有启示意义。

{"title":"Sex-Dependent Programming of Glucose and Fatty Acid Metabolism in Mouse Offspring by Maternal Protein Restriction","authors":"Esther M.E. van Straten PhD , Vincent W. Bloks , Theo H. van Dijk PhD , Julius F.W. Baller , Nicolette C.A. Huijkman , Irma Kuipers PhD , Henkjan J. Verkade MD, PhD , Torsten Plösch PhD","doi":"10.1016/j.genm.2012.01.004","DOIUrl":"10.1016/j.genm.2012.01.004","url":null,"abstract":"<div><h3>Background</h3><p><span>Nutritional conditions during fetal life influence the risk of the development of metabolic syndrome and cardiovascular diseases in adult life (metabolic programming). </span>Impaired glucose tolerance and dysregulated fatty acid metabolism are hallmarks of metabolic syndrome.</p></div><div><h3>Objective</h3><p>We aimed to establish a mouse model of metabolic programming focusing on the sex-specific effects of a maternal low-protein diet during gestation on glucose and lipid metabolism in the adult offspring.</p></div><div><h3>Methods</h3><p>Pregnant C57BL/6 mice received a control or a low-protein diet (18% vs 9% casein) throughout gestation. Male and female offspring received a low-fat or a high-fat diet from 6 to 22 weeks of age.</p></div><div><h3>Results</h3><p>Maternal low-protein diet during gestation led to deteriorated insulin sensitivity on high-fat feeding in female offspring, as determined by biochemical and microarray analyses. Female offspring of control diet–fed dams were relatively resistant to high-fat diet–induced metabolic dysregulation. In contrast, maternal low-protein diet did not specifically affect the metabolic parameters addressed in male offspring. In males, the high-fat diet led to insulin insensitivity regardless of the diet of the dam.</p></div><div><h3>Conclusions</h3><p>Our findings show that fetal malnutrition<span> has a limited impact on male mouse offspring, yet it does influence the metabolic response to a high-fat diet in females. These findings may have implications for future early diagnostics in metabolic syndrome and for the development of sex-specific treatment regimens.</span></p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 3","pages":"Pages 166-179.e13"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30482688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Diabetic Polyneuropathy Relates to Bone Metabolism and Markers of Bone Turnover in Elderly Patients With Type 2 Diabetes: Greater Effects in Male Patients 糖尿病多发神经病变与老年2型糖尿病患者骨代谢和骨转换标志物相关:男性患者的影响更大

Gender Medicine

Pub Date : 2012-06-01 DOI: 10.1016/j.genm.2012.03.004

Sazan Rasul MD , Aysegul Ilhan MD , Ludwig Wagner MD , Anton Luger MD , Alexandra Kautzky-Willer MD

Background

There is evidence that diabetic polyneuropathy (PNP) is associated with reduced bone mineral density (BMD) in type 1 diabetes but little is known about the impact of diabetic PNP on bone metabolism in type 2 diabetes.

Objectives

The aim of this study was to evaluate differences in bone metabolism by measuring markers of bone turnover and BMD in men and postmenopausal women with type 2 diabetes and diabetic PNP compared with those without PNP. Gender differences were analyzed for both groups of patients.

Methods

One hundred twenty patients with type 2 diabetes, 68 without PNP (43 men, 25 women, mean age 62 [8] years) and 52 with PNP (28 men, 24 women, mean age 64 [8] years) were studied. Clinical parameters with bone turnover biomarkers such as osteocalcin, bone alkaline phosphatase, procollagen type 1 amino-terminal propeptide, and carboxy-terminal telopeptide of type 1 collagen were measured in all patients. Dual energy x-ray absorptiometry to evaluate BMD was performed in a subgroup of patients.

Results

After controlling for age, body mass index, duration of diabetes, smoking, glycosylated hemoglobin, homeostasis model assessment index for insulin resistance, serum C-reactive protein, creatinine, calcium, gamma-glutamyltransferase, parathyroid and sex hormones levels, presence of micro/macrovascular complications, statin- as well as diabetes-related therapies, levels of carboxy-terminal telopeptide of type 1 collagen and procollagen type 1 amino-terminal propeptide were significantly higher among patients with PNP when compared with patients without PNP (P = 0.01 and P = 0.03, respectively). Differences in bone biomarkers were more pronounced among men with diabetes. BMD did not differ significantly between patients with and without PNP, independent of gender.

Conclusions

Male patients with PNP exhibit a higher rate of bone turnover than men without PNP. High rate of bone turnover increases the susceptibility for developing osteoporosis. Prevention of diabetic PNP might also reduce the incidence of osteoporosis and fractures in patients with type 2 diabetes.

有证据表明，糖尿病多发神经病变(PNP)与1型糖尿病患者骨密度(BMD)降低有关，但对糖尿病多发神经病变对2型糖尿病患者骨代谢的影响知之甚少。本研究的目的是通过测量2型糖尿病和糖尿病性PNP的男性和绝经后女性与无PNP的男性和女性的骨转换和骨密度指标来评估骨代谢的差异。分析两组患者的性别差异。方法选取120例2型糖尿病患者，其中无PNP患者68例(男性43例，女性25例，平均年龄62[8]岁)，有PNP患者52例(男性28例，女性24例，平均年龄64[8]岁)。测定所有患者骨转换生物标志物骨钙素、骨碱性磷酸酶、1型前胶原氨基末端前肽、1型胶原羧基末端末端肽等临床参数。双能x线吸收仪评估骨密度在一个亚组的患者。结果在控制了年龄、体重指数、糖尿病病程、吸烟、糖化血红蛋白、胰岛素抵抗稳态模型评估指标、血清c反应蛋白、肌酐、钙、γ -谷氨酰转移酶、甲状旁腺和性激素水平、微/大血管并发症、他汀类药物及糖尿病相关治疗后，PNP患者1型胶原羧基端肽和前胶原1型氨基端前肽水平显著高于无PNP患者(P = 0.01和P = 0.03)。在患有糖尿病的男性中，骨骼生物标志物的差异更为明显。骨密度在PNP患者和非PNP患者之间无显著差异，与性别无关。结论小型PNP患者骨更新率高于非PNP患者。高的骨转换率增加了骨质疏松症的易感性。预防糖尿病性PNP也可能降低2型糖尿病患者骨质疏松和骨折的发生率。

{"title":"Diabetic Polyneuropathy Relates to Bone Metabolism and Markers of Bone Turnover in Elderly Patients With Type 2 Diabetes: Greater Effects in Male Patients","authors":"Sazan Rasul MD , Aysegul Ilhan MD , Ludwig Wagner MD , Anton Luger MD , Alexandra Kautzky-Willer MD","doi":"10.1016/j.genm.2012.03.004","DOIUrl":"10.1016/j.genm.2012.03.004","url":null,"abstract":"<div><h3>Background</h3><p><span>There is evidence that diabetic polyneuropathy (PNP) is associated with reduced bone mineral density (BMD) in </span>type 1 diabetes<span> but little is known about the impact of diabetic PNP<span> on bone metabolism in type 2 diabetes.</span></span></p></div><div><h3>Objectives</h3><p><span>The aim of this study was to evaluate differences in bone metabolism by measuring markers of bone turnover and BMD in men and </span>postmenopausal women with type 2 diabetes and diabetic PNP compared with those without PNP. Gender differences were analyzed for both groups of patients.</p></div><div><h3>Methods</h3><p>One hundred twenty patients with type 2 diabetes, 68 without PNP (43 men, 25 women, mean age 62 [8] years) and 52 with PNP (28 men, 24 women, mean age 64 [8] years) were studied. Clinical parameters with bone turnover biomarkers such as osteocalcin<span><span><span><span>, bone alkaline phosphatase, </span>procollagen type 1 amino-terminal propeptide, and carboxy-terminal telopeptide of </span>type 1 collagen were measured in all patients. Dual energy x-ray </span>absorptiometry to evaluate BMD was performed in a subgroup of patients.</span></p></div><div><h3>Results</h3><p><span><span>After controlling for age, body mass index<span>, duration of diabetes, smoking, glycosylated hemoglobin, </span></span>homeostasis model assessment index for insulin resistance, serum C-reactive protein, creatinine, calcium, gamma-glutamyltransferase, parathyroid and sex hormones levels, presence of micro/macrovascular complications, statin- as well as diabetes-related therapies, levels of carboxy-terminal telopeptide of type 1 collagen and procollagen type 1 amino-terminal propeptide were significantly higher among patients with PNP when compared with patients without PNP (</span><em>P</em> = 0.01 and <em>P =</em> 0.03, respectively). Differences in bone biomarkers were more pronounced among men with diabetes. BMD did not differ significantly between patients with and without PNP, independent of gender.</p></div><div><h3>Conclusions</h3><p><span>Male patients with PNP exhibit a higher rate of bone turnover than men without PNP. High rate of bone turnover increases the susceptibility for developing osteoporosis. Prevention of diabetic PNP might also reduce the incidence of osteoporosis and fractures </span>in patients with type 2 diabetes.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 3","pages":"Pages 187-196"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30573881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 33

Evaluating Sex and Gender Competencies in the Medical Curriculum: A Case Study 评估医学课程中的性别和性别能力:个案研究

Gender Medicine

Pub Date : 2012-06-01 DOI: 10.1016/j.genm.2012.01.006

Virginia M. Miller PhD , Priscilla M. Flynn MPH, DrPH , Keith D. Lindor MD

Background

Sex and gender differences exist in the manifestation and prevalence of many conditions and diseases. Yet many clinician training programs neglect to integrate this information across their curricula.

Objective

This study aimed to measure the sex and gender medical knowledge of medical students enrolled in a program without an explicit directive to integrate sex and gender differences across a block system of core subjects.

Methods

A forced-choice instrument consisting of 35 multiple-choice and true or false questions was adapted from an evaluation tool used in the European Curriculum in Gender Medicine held at Charité Hospital, Berlin, in September 2010.

Results

Fourth-year (response rate 93%) and second-year (response rate 70%) students enrolled in Mayo Medical School completed the instrument. More than 50% of students in both classes indicated that topics related to sex and gender were covered in gynecology, cardiology, and pediatrics, and <20% of students indicated inclusion of such topics in nephrology, neurology, and orthopedics. More than twice as many second-year students indicated that topics dealing with sex and gender were included in immunology course material compared with fourth-year students. A consensus of written comments indicated that concepts of sex and gender-based medicine need to be embedded into existing curriculum, with an emphasis on clinically relevant information.

Conclusions

Although this study represents only one medical school in the United States, information regarding sex and gender aspects of medicine is not consistently included in this curriculum without an explicit directive. These results can provide guidance for curriculum improvementto train future physicians.

性别和性别差异存在于许多病症和疾病的表现和流行中。然而，许多临床医生培训项目忽视了将这些信息整合到他们的课程中。目的本研究旨在了解在核心科目体系中未明确整合性别差异的医学生的性别和性别医学知识。方法采用一种强迫选择工具，由35道选择题和真假题组成，该工具改编自2010年9月在柏林慈善医院举行的欧洲性别医学课程中使用的评估工具。结果梅奥医学院四年级(93%)和二年级(70%)学生完成了问卷调查。在这两门课上，超过50%的学生表示妇科、心脏病学和儿科的课程涵盖了与性别和社会性别相关的主题，20%的学生表示肾脏病学、神经学和骨科的课程包含了这类主题。与四年级学生相比，有两倍多的二年级学生表示，免疫学课程材料中包含了涉及性和社会性别的主题。书面评论的共识表明，需要将性别和基于性别的医学概念纳入现有课程，并强调临床相关信息。结论:虽然这项研究只代表了美国的一所医学院，但在没有明确指示的情况下，关于医学的性别和性别方面的信息并没有始终包含在课程中。这些结果可以为课程改进提供指导，以培养未来的医师。

{"title":"Evaluating Sex and Gender Competencies in the Medical Curriculum: A Case Study","authors":"Virginia M. Miller PhD , Priscilla M. Flynn MPH, DrPH , Keith D. Lindor MD","doi":"10.1016/j.genm.2012.01.006","DOIUrl":"10.1016/j.genm.2012.01.006","url":null,"abstract":"<div><h3>Background</h3><p>Sex and gender differences exist in the manifestation and prevalence of many conditions and diseases. Yet many clinician training programs neglect to integrate this information across their curricula.</p></div><div><h3>Objective</h3><p>This study aimed to measure the sex and gender<span> medical knowledge of medical students enrolled in a program without an explicit directive to integrate sex and gender differences across a block system of core subjects.</span></p></div><div><h3>Methods</h3><p>A forced-choice instrument consisting of 35 multiple-choice and true or false questions was adapted from an evaluation tool used in the European Curriculum in Gender Medicine held at Charité Hospital, Berlin, in September 2010.</p></div><div><h3>Results</h3><p>Fourth-year (response rate 93%) and second-year (response rate 70%) students enrolled in Mayo Medical School completed the instrument. More than 50% of students in both classes indicated that topics related to sex and gender were covered in gynecology<span><span>, cardiology<span><span>, and pediatrics, and <20% of students indicated inclusion of such topics in </span>nephrology, </span></span>neurology<span><span>, and orthopedics. More than twice as many second-year students indicated that topics dealing with sex and gender were included in </span>immunology course material compared with fourth-year students. A consensus of written comments indicated that concepts of sex and gender-based medicine need to be embedded into existing curriculum, with an emphasis on clinically relevant information.</span></span></p></div><div><h3>Conclusions</h3><p>Although this study represents only one medical school in the United States, information regarding sex and gender aspects of medicine is not consistently included in this curriculum without an explicit directive. These results can provide guidance for curriculum improvement\u0000to train future physicians.</p></div>","PeriodicalId":55124,"journal":{"name":"Gender Medicine","volume":"9 3","pages":"Pages 180-186.e3"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.genm.2012.01.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30435722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17