Cardiometabolic diseases (CMDs) are a leading cause of death worldwide. Men and women show strong differences in the extent and severity of CMDs and the effectiveness of their treatment. More is still needed to enable prevention and treatment tailored to men and women. Previous studies showed that risk factors are different in men and women, with some also showing a sex-specific effect on the disease. CMDs are age-related, however, and the older a person gets the more common it is. The aging process also differs between men and women. There is not yet a complete picture of how sex-specific CMD risk factors change with age.
In this study, Daria Zhernakova and Jingyuan Fu used the Lifelines cohort. This is a large cohort from the northern Netherlands consisting of more than 167,000 individuals from the general population. This allowed them to examine how different age-related changes are in men versus women. They first examined 51 clinical phenotypes and CMD risk factors in the entire cohort and then zoomed in on a subset of 1,440 individuals to study age-dependent sex differences in circulating protein levels and lipoprotein parameters.
Sex differences in CMD risk factors are age-dependent
Their research shows that sex differences are widespread, with about one-third of these sex differences dependent on age. For some factors, such as BMI, the difference between men and women is independent of age. For other factors, such as systolic blood pressure and lipid levels, this difference actually appears to change with age. A detailed examination of lipoprotein levels showed several age-dependent patterns that are strikingly different between men and women. Aging in women is strongly influenced by menopause. About 62% of the blood parameters tested showed strong differences before and after menopause, including electrolyte levels and liver and kidney function parameters. However, the major CMD risk factors did not show strong menopause-associated effects.
'Take sex and age into account'
These results highlight the importance of taking into account both age and sex when assessing individual risk of CMD based on risk factors. Moreover, the results suggest that sex-dependent aging may underlie sex differences in CMDs. According to Zhernakova and Fu, their results contribute to a better understanding of the relationship between age, sex and the development of CMD.
The publication in Nature Cardiovascular Research can be read here: Age-dependent sex differences in cardiometabolic risk factors | Nature Cardiovascular Research