Sex differences in the longitudinal association between metabolomic biomarkers and carotid artery plaques

The development of carotid artery atherosclerosis differs between men and women. We examined the role of the metabolome in these sex differences in Australian adults.

Data is from the Australian Childhood Determinants of Adult Health (CDAH) study where 73 metabolomic biomarkers were measured at ages 26-36 years (2004-06) and carotid artery plaques were measured at ages 36-46 years (2014-19). We identified metabolites that modified the effect of sex on plaques in log-binomial regression models. Sex-specific regressions were performed for metabolic biomarkers that had a sex-specific association with plaques. There were 638 participants (53 % women, mean [SD] age 31.2 [2.6] years) in the analysis. Interactions were significant for sex with omega-3 fatty acid, docosahexaenoic acid (DHA), saturated fat percentage, and albumin on their association with plaques. Inverse associations with plaques in women, but not men, were found for saturated fat percentage in adjusted analysis (RR/SD increase 0.52 95 % CI 0.36-0.79; p < 0.001). Albumin signal area was positively associated with plaques in women in adjusted analysis (RR/SD increase 1.56 95 % CI 1.33-2.15; p = 0.006).

Associations between metabolic biomarkers and plaques were different in women compared with men, which may reveal sex-specific factors for atherosclerosis in women.