性别相关的生物标志物 慢性病进展和死亡率的差异
Thomas McDonnell1,2, Anthony Onoja3, Nicolas Vuilleumier4
1Donal O'Donoghue Renal Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Clinical journal of the American Society of Nephrology : CJASN
|February 5, 2026
概括
患有慢性病 (CKD) 的男性面临更高的衰竭和死亡风险. 生物标志物差异,特别是在炎症和矩阵沉积方面,解释了这些基于性别的结果差异,这表明男性CKD预后更差的生物基础.
科学领域:
- 腎病學和泌尿病學.
- 生物标志物和诊断方法
- 基于性别的医学
背景情况:
- 与女性相比,患有慢性病 (CKD) 的男性表现较差.
- 这种差异并不能完全由共同疾病或社会文化因素来解释.
- 研究生物标志物的基于性别的差异可能会阐明潜在的风险机制.
研究的目的:
- 探索特定生物标志物的基于性别的差异是否有助于男性和女性之间观察到的CKD结果差异.
- 确定与损伤,纤维化,炎症和心血管压力相关的特定生物标志物,这些生物标志物在CKD患者的性别之间存在差异.
主要方法:
- 分析了来自NURTuRE-CKD队列的1,680名男性和1,204名女性的非透析依赖性CKD.
- 测量21个与损伤,纤维化,炎症和心血管应激相关的生物标志物.
- 使用多变量Cox和Fine和Gray模型进行结果评估,并使用ANCOVA进行生物标志物比较,并根据临床因素进行调整.
主要成果:
- 在对照组和CKD参与者中观察到生物标志物度的显著性别差异.
- 患有CKD的男性表现出较高水平的炎症和细胞外矩阵沉积生物标志物 (例如KIM-1,GDF-15).
- 患有CKD的女性具有较高的矩阵周转和降解标志物 (例如,骨活素,MMP-9).
- 在调整了生物标志物差异后,消除了与男性性别相关的功能衰竭和死亡率的高风险.
结论:
- 男性性别独立地与慢性病患者功能衰竭和死亡率增加的风险有关.
- 性别特定的生物标志物概况反映了不同的生物途径,是这些结果差异的基础.
- 对这些生物标志物的调整可以中和男性的风险增加,突出显示CKD性别差异的生物学基础.
- 研究结果表明,在CKD管理中,有潜在的性别特异性治疗点.
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