Sex-Based Differences in Cardiometabolic Biomarkers

Area of Science:

• Cardiovascular Medicine
• Biomarker Research
• Sex Differences in Health

Background:

• Limited data exist comparing cardiovascular disease (CVD) biomarker profiles between sexes in the general population.
• Understanding sex-based differences in biomarkers is crucial for personalized CVD risk assessment and management.
• Previous studies have not comprehensively analyzed multiple biomarker categories across distinct pathophysiological pathways.

Purpose of the Study:

• To analyze sex-based differences in a wide array of biomarkers reflecting distinct pathophysiological pathways.
• To account for confounding factors such as CVD risk factors, body composition, and cardiac morphology in the comparison.
• To identify specific biomarkers that exhibit significant sex-based variations in the general population.

Main Methods:

• A cross-sectional analysis of the Dallas Heart Study, a multiethnic population-based cohort.
• Evaluation of associations between sex and 30 distinct biomarkers across 6 pathophysiological categories.
• Multivariable linear regression models were adjusted for age, race, CVD risk factors, kidney function, insulin resistance, body composition, and cardiac morphology.

Main Results:

• Significant sex-based differences were observed in multiple biomarker categories, including lipids, adipokines, inflammation, endothelial dysfunction, myocyte injury/stress, and kidney function.
• Women exhibited higher levels of HDL cholesterol, leptin, d-dimer, and NT-proBNP, while men had higher levels of LDL cholesterol, adiponectin, and hs-Troponin T.
• Adjusted models revealed distinct sex-specific patterns in biomarkers related to adiposity, endothelial function, inflammation, and cardiac stress.

Conclusions:

• Biomarker profiles demonstrate significant sex-based differences in the general population.
• These differences are particularly pronounced for biomarkers associated with adiposity, endothelial dysfunction, inflammatory cell recruitment, and cardiac stress/injury.
• Further research is necessary to determine if these biomarker-defined pathophysiological processes contribute to sex-based disparities in CVD development and outcomes.