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Sexual Dimorphism in Cardiovascular Biomarkers: Clinical and Research Implications
Emily S Lau1, Aleksandra Binek2, Sarah J Parker2
1Division of Cardiology (E.S.L.), Massachusetts General Hospital, Boston.
Insights
Biological sex influences cardiovascular disease biomarkers. Understanding these sex differences in biomarkers can improve diagnosis and treatment for both men and women. This review explores these critical distinctions.
Area of Science:
- Cardiovascular Medicine
- Biomarker Research
- Sex-Based Biology
Background:
- Sex-based differences in cardiovascular disease (CVD) are known, but underlying mechanisms and clinical applications are not fully understood.
- Blood-based biomarkers are crucial for studying biological pathways in CVD.
- Investigating sexual dimorphism in biomarker-CVD relationships can improve understanding of female CVD pathogenesis and personalized care.
Purpose of the Study:
- To review how biological sex affects blood-based biomarker levels and their impact on CVD outcomes.
- To summarize sex-specific differences in key cardiovascular biomarkers across major biological pathways.
- To provide recommendations for future research and clinical innovation based on sex differences in biomarkers.
Main Methods:
- Literature review focusing on sex differences in blood-based cardiovascular biomarkers.
- Analysis of biomarker associations with CVD outcomes stratified by sex.
- Synthesis of data on sex-specific biomarker profiles in myocardial stretch/injury, inflammation, adipose tissue metabolism, and fibrosis pathways.
Main Results:
- Biological sex is associated with differential levels of blood-based biomarkers.
- Sex influences how biomarkers affect CVD outcomes.
- Key differences exist in cardiovascular biomarkers related to myocardial stretch/injury, inflammation, adipose tissue metabolism, and fibrosis between men and women.
Conclusions:
- Understanding sex differences in blood-based biomarkers is essential for advancing CVD research.
- Translating knowledge of sexual dimorphism in biomarkers can lead to improved, individualized patient care for CVD.
- Further research and clinical innovation are needed to leverage these sex-specific insights.
Abstract:
Sex-based differences in cardiovascular disease presentation, diagnosis, and response to therapies are well established, but mechanistic understanding and translation to clinical applications are limited. Blood-based biomarkers have become an important tool for interrogating biologic pathways. Understanding sexual dimorphism in the relationship between biomarkers and cardiovascular disease will enhance our insights into cardiovascular disease pathogenesis in women, with potential to translate to improved individualized care for men and women with or at risk for cardiovascular disease. In this review, we examine how biologic sex associates with differential levels of blood-based biomarkers and influences the effect of biomarkers on disease outcomes. We further summarize key differences in blood-based cardiovascular biomarkers along central biologic pathways, including myocardial stretch/injury, inflammation, adipose tissue metabolism, and fibrosis pathways in men versus women. Finally, we present recommendations for leveraging our current knowledge of sex differences in blood-based biomarkers for future research and clinical innovation.
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