Effect of Perinatal Bisphenol A Exposure on Serum Lipids and Lipid Enzymes in Offspring Rats of Different Sex

Rats were exposed to1 or 10 μg/mL bisphenol A （BPA） in water during pregnancy and lactation. Offspring rats were given normal water and a standard diet from weaning to postnatal day （PND） 50. Perinatal exposure to BPA resulted in significantly increased body weight, visceral adipose tissue, abnormal serum lipids, and lower adiponectin （ADP） levels in both female and male offspring rats. Liver adipose triglyceride lipase （Atgl） mRNA levels and ADP protein in visceral adipose tissue were significantly decreased in BPA-exposed offspring rats. In both female or male offspring rats, obesity and dyslipidemia induced by perinatal exposure to BPA were associated with down regulation of Atgl mRNA in liver and ADP protein in visceral adipose tissue.

Hard life for sons in the nest?Sex-dependent offspring mortality in Great Tits in urban and forest areas

Sex-biased mortality can occur in birds during development,for example due to sexual differences in energy requirement and/or environmental sensitivity,or the effects of sex hormones or sex differences in the expression of mutations linked to sex chromosomes.The extent of sex-bias in mortality may also be related to environmental conditions that influence offspring development and survival.Urban areas often provide poorer conditions for nestling development resulting in higher offspring mortality compared to natural areas,which may accelerate sex differences in offspring mortality in cities.To test this hypothesis,we examined the sex ratio of dead offspring in Great Tits(Parus major),using 427 samples of unhatched eggs and dead nestlings collected in two urban and two forest sites between 2013 and 2019.The ratio of males in the whole sample of dead offspring(56.9%)was significantly higher than expected by an 1:1 ratio,and the strongest sex biases were detected in urban areas(57.6%males)and in young nestlings(<14 days old,59.0%males).However,the sex ratios of dead offspring did not differ significantly among study sites and between offspring developmental stages.29.3%of unhatched eggs contained a visible embryo,and the proportion of embryo-containing unhatched eggs did not differ significantly between urban and forest study sites.These results suggest male-biased offspring mortality in Great Tits,and highlight the need of large datasets to detect subtle differences between habitats and developmental stages.

Study on sex differences and potential clinical value of threedimensional computerized tomography pelvimetry in rectal cancer patients

BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.

Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States

BACKGROUND The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.AIM To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips.We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.METHODS Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States(8-18 years;50%male)without hip pain.Proximal femoral measurements including the femoral head diameter,femoral head volume,residual volume,asphericity index,and local diameter difference were used to evaluate femoral head sphericity.RESULTS In both sexes,the residual volume increased by age(P<0.05).Despite significantly smaller femoral head size in older ages(>13 years)in females,there were no sex-differences in residual volume and aspherity index.There were no age-related changes in mean diameter difference in both sexes(P=0.07)with no significant sex-differences across different age groups(P=0.06).In contrast,there were significant increases in local aspherity(maximum diameter difference)across whole surface of the femoral head and all quadrants except the inferior regions in males(P=0.03).There were no sex-differences in maximum diameter difference at any regions and age group(P>0.05).Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head(P=0.024).CONCLUSION There is a substantial localized asphericity in asymptomatic hips which increases with age in.While 2D measured alpha angle can capture overall asphericity of the femoral head,it may not be sensitive enough to represent regional asphericity patterns.

Keep in mind sex differences when prescribing psychotropic drugs

Women represent the majority of patients with psychiatric diagnoses and also the largest users of psychotropic drugs.There are inevitable differences in efficacy,side effects and long-term treatment response between men and women.Psychopharmacological research needs to develop adequately powered animal and human trials aimed to consider pharmacokinetics and pharmacodynamics of central nervous system drugs in both male and female subjects.Healthcare professionals have the responsibility to prescribe sex-specific psychopharmacotherapies with a priority to differentiate between men and women in order to minimize adverse drugs reactions,to maximize therapeutic effectiveness and to provide personalized management of care.

Sex differences in the association between the muscle quality index and the incidence of depression: A cross-sectional study

BACKGROUND Depression presents significant challenges to mental health care.Although phy-sical activity is highly beneficial to mental and physical health,relatively few stu-dies have conducted on the relationship between them.AIM To investigate the association between muscle quality index(MQI)and incidence of depression.METHODS The data used in this cross-sectional study were obtained from the 2011-2014 National Health and Nutritional Examination Survey,which included informa-tion on MQI,depression,and confounding factors.Multivariable logistic regre-ssion models were employed,while taking into account the complex multi-stage sampling design.A restricted cubic spline model was utilized to investigate the non-linear relationship between the MQI and depression.Additionally,subgroup analyses were performed to identify influential factors.RESULTS The prevalence of depression in this population was 8.44%.With the adjusted model,the MQI was associated with depression in females(odds ratio=0.68,95%confidence interval:0.49-0.95)but not in males(odds ratio=1.08,95%confidence interval:0.77-1.52).Restricted cubic spline adjustment of all covariates showed a significant negative non-linear relationship between depression and the MQI in females.The observed trend indicated an 80%decrease in the risk of depression for each unit increase in MQI,until a value of 2.2.Subsequently,when the MQI exceeded 2.2,the prevalence of depression increased by 20%for every unit increase in the MQI.Subgroup analyses further confirmed that the MQI was negatively associated with de-pression.CONCLUSION The MQI was inversely correlated with depression in females but not males,suggesting that females with a higher MQI might decrease the risk of depression.

High school sports programs differentially impact participation by sex

Background： Among numerous health benefits, sports participation has been shown to reduce the risk of overweight and obesity in children and adolescents. Schools represent an ideal environment for increasing sports participation, but it is unclear how access and choice influence participation and whether characteristics of the school sports program differentially influence boys＇ and girls＇ participation. The purpose of this study was to evaluate the characteristics of high school athletic programs and determine the extent to which these characteristics influenced boys＇ and girls＇ sports team participation. Methods： Longitudinal telephone surveys were conducted with 1244 New Hampshire and Vermont students. Students self-reported their sports team participation at baseline （elementary school） and follow-up （high school）. High school personnel were surveyed to assess sports oppor- tunities, which were defined for this analysis as the number of sports offered per 100 students （i.e., choice） and the percent of sports offered that did not restrict the number of players （i.e., access）. Results： Approximately 70% of children participated on at least one sports team, including 73% of boys and 66% of girls. We detected sta- tistically significant interactions between sex and two school opportunity variables： 1） the number of sports offered per 100 students （i.e., choice） and 2） the percent of sports offered that did not restrict the number of players （i.e., access）. After controlling for children＇s baseline sports participation and other covariates, boys were more likely to play on at least one sports team per year if their school did not restrict participation in the most popular sports （relative risk, RR = 1.12, p 〈 0.01）; in contrast, girls were more likely to play on at least one sports team per year if their school offered a wider variety of sports （RR = 1.47, p 〈 0.001）. Conclusion： Sports participation has previously been shown to confer a number of health benefits; as such, school sports programs may be an important, effective, and underused target for public health efforts, including obesity prevention programs. Efforts to increase physical activity among youth should consider both access and choice in school athletic programs. Schools may need to use different strategies to increase sports participation in boys and girls.

Sex dimorphism and metabolic profiles in management of metabolic-associated fatty liver disease

Metabolic-associated fatty liver disease(MAFLD)refers to the build-up of fat in the liver associated with metabolic dysfunction and has been estimated to affect a quarter of the population worldwide.Although metabolism is highly influenced by the effects of sex hormones,studies of sex differences in the incidence and progression of MAFLD are scarce.Metabolomics represents a powerful approach to studying these differences and identifying potential biomarkers and putative mechanisms.First,metabolomics makes it possible to obtain the molecular phenotype of the individual at a given time.Second,metabolomics may be a helpful tool for classifying patients according to the severity of the disease and obtaining diagnostic biomarkers.Some studies demonstrate associations between circulating metabolites and early and established MAFLD,but little is known about how metabolites relate to and encompass sex differences in disease progression and risk management.In this review,we will discuss the epidemiological metabolomic studies for sex differences in the development and progression of MAFLD,the role of metabolic profiles in understanding mechanisms and identifying sex-dependent biomarkers,and how this evidence may help in the future management of the disease.

Sex differences in the scored Patient-Generated Subjective Global Assessment in 19,528 cancer patients

Background:The scored Patient-Generated Subjective Global Assessment(PG-SGA)has been widely used to assess the nutritional status of cancer patients.The purpose of this study is to compare the differences in PG-SGA scores and the 7 domain scores of the PG-SGA in male and female cancer patients.Methods:This study was conducted at 72 hospitals from July 2013 to December 2018,a part of the Investigation on Nutritional Status and its Clinical Outcomes of Common Cancers.The PG-SGA was recorded to evaluate the nutritional status of patients.A total of 19,528 patients with 13 common malignancies were included in this study.Student t test and the χ^(2) test were applied to analyze the sex diferences in the 7 domain scores.The Cancer Genome Atlas(TCGA)database was used to analyze the expression levels of symptom-related genes.Results:There were significant sex dfferences in the PG-SGA(P=0.032),notably in patients with gastric cancer(male vs female:9.09±4.86 vs 9.58±5.07,P=0.005)and esophageal cancer(9.64±4.90 vs 10.46±4.96,P=0.011)and the average total PG-SGA of female patients was slightly higher than that of male patients(7.64±4.98 vs 7.77±5.14).The differences were mainly related to the weight,eating,symptom,as well as activity and physical function scores in the stratified analysis.Possible causes of the sex differences were the rates of nausea,vomiting,dry mouth,and other symptoms,in both gastric and esophageal cancer patients.Analysis of the TCGA database suggested that most of the related genes were sex neutral,except for genes related to dysphagia in gastric cancer(VEGFC was higher in female patients,VEGFA and VEGFB higher in male patients).Conclusions:There are sex differences in the PG-SGA scores in patients with various tumor types(female patients generally had higher scores than male patients),with differences mainly in the weight,eating,symptom,as well as activity and physical function scores.The sex differences in PG-SGA scores might be due to the differences in the clinical manifestations of the disease,and further studies should be carried out to investigate other factors influencing the PG-SGA scores in cancer patients.This study provides basic data supporting the individualized nutritional treatment of cancer patients in clinical practice.

Kidney disease in patients with chronic liver disease:Does sex matter?

Kidney disease in patients with liver disease is serious and increases mortality.Up to 50%of patients hospitalized experience an episode of acute kidney injury.In general,men with liver disease are thought to be at increased risk of kidney disease.However,this association should be considered with caution because most studies use creatinine-based inclusion criteria,which is negatively biased against women.In this review,we synthesize data on sex differences in kidney disease in patients with chronic liver disease in the clinical setting and discuss potential physiologic underpinnings.

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

Alanine aminotransferase(ALT)serum levels increase because of hepatocellular damage.Metabolic dysfunction-associated fatty liver disease(MAFLD),which identifies steatotic liver disease(SLD)associated with≥2 metabolic abnormalities,has prominent sexual differences.The Metabolic Syndrome defines a cluster comprising abdominal obesity,altered glucose metabolism,dyslipidemia,and hypertension.Male sex,body mass index,glucose,lipids,ferritin,hypertension,and age independently predict ALT levels among blood donors.Over the last few decades,the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference ranges.With this backset,Chen et al have recently published a study which has two main findings.First,>80%of indi-viduals with MAFLD had normal ALT levels.Second,there was a linear increa-sing trend in the association between cumulative excess high-normal ALT levels and the rate of incident MAFLD.This study has biologically credible findings.However,it inaccurately considered sex differences in the MAFLD arena.Therefore,future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.

Changing Nasopharyngeal Carcinoma Survival in Southern China during 2000-2015: Results of a Retrospective Cohort Study

Objective: Around 50% of new nasopharyngeal carcinoma (NPC) cases come from China. The present study aimed to update the surveillance of NPC survival in southern China, and investigate the survival disparities between sexes within this patient population. Methods: Patients diagnosed with primary and invasive NPC between 2000 and 2015 were included in this study. Data on demographics, diagnosis, and follow-up to December 2020 were collected. Patients were stratified by diagnosis period, sex, and age at diagnosis. Survival analysis employed cohort and Life Table methods, Kaplan-Meier curves, log-rank tests, and Cox regression. Results: The study included 32,901 patients, of whom 69.6% were males. The overall 5-year survival rate rose from 69.6% in 2000-2003 to 83.3% in 2013-2015, with a consistent average increase of 3.3% every 3 years. For males, the 5-year survival rate increased from 66.3% to 82.0%, faster than females. Kaplan-Meier curves demonstrated a significantly higher survival rate for females than males, and subgroup analysis confirmed this advantage. The Cox proportional hazards model confirmed the lower mortality risk for females (HR 0.75, 95% CI: 0.71 - 0.78), patients with younger ages at diagnosis, and patients diagnosed in more recent years (All P Conclusions: The 5-year survival rate for NPC patients in southern China has significantly and steadily improved from 2000 to 2015, indicating the improved quality of cancer care in China. The survival advantage of female patients is not limited to younger patients but is also observed in postmenopausal patients, despite the gradual narrowing of the gender gap.

Age and Sex-related Dendritic Changes in the Visual Cortex of the Rat

Visual functions undergo an age-related degradation. However, the neural mechanisms underlying these changes are not yet clear. This study was designed to investigate the influence of age and sex on the anatomy of the rat＇s visual cortex. Dendritic tree extent and spine density were examined in young adult rats （2-3 months） and aged male and female rats （22-24 months） using a modified Golgi-Cox staining method. A sex difference in dendritic branching of the pyramidal cells was found among young adults. However, this difference disappeared during aging, due to a reduction in branching with age for males but not for females. Moreover, the pyramidal cells of young males also have a greater spine density. Although there was a reduction in spine density with age for both sexes, this reduction was more pronounced for males, resulting in a disappearance of sex difference with age. Thus these results suggest that aging could lead to the degeneration of dendrites, which might contribute to the degradation of age-related visual functions. Also the results indicate that age-related degeneration of dendrites is more severe for males than for females.

Influence of biological sex and exercise on murine cardiac metabolism

Although the structural and functional effects of exercise on the heart are well established,the metabolic changes that occur in the heart during and after exercise remain unclear.In this study,we used metabolomics to assess time-dependent changes in the murine cardiac metabolome following 1 session of treadmill exercise.After the exercise bout,we also recorded blood lactate,glucose,and ketone body levels and measured cardiac mitochondrial respiration.In both male and female mice,moderate-and high-intensity exercise acutely increased blood lactate levels.In both sexes,low-and moderate-intensity exercise augmented circulating 3-hydroxybutryrate levels immediately after the exercise bout;however,only in female mice did high-intensity exercise increase 3-hydroxybutyrate levels,with significant increases occurring 1 h after the exercise session.Untargeted metabolomics analyses of sedentary female and male hearts suggest considerable sex-dependent differences in basal cardiac metabolite levels,with female hearts characterized by higher levels of pantothenate,pyridoxamine,homoarginine,tryptophan,and several glycerophospholipid and sphingomyelin species and lower levels of numerous metabolites,including acetyl coenzyme A,glucuronate,gulonate,hydroxyproline,prolyl-hydroxyproline,carnosine,anserine,and carnitinylated and glycinated species,as compared with male hearts.Immediately after a bout of treadmill exercise,both male and female hearts had higher levels of corticosterone;however,female mice showed more extensive exercise-induced changes in the cardiac metabolome,characterized by significant,time-dependent changes in amino acids(e.g.,serine,alanine,tyrosine,tryptophan,branched-chain amino acids)and the ketone body 3-hydroxybutyrate.Results from experiments using isolated cardiac mitochondria suggest that high-intensity treadmill exercise does not acutely affect respiration or mitochondrial coupling;however,female cardiac mitochondria demonstrate generally higher adenosine diphosphate sensitivity compared with male cardiac mitochondria.Collectively,these findings in mice reveal key sex-dependent differences in cardiac metabolism and suggest that the metabolic network in the female heart is more responsive to physiological stress caused by exercise.

Sex-based differences in histology,staging,and prognosis among 2983 gastric cancer surgery patients

BACKGROUND Few studies have been conducted on sex differences in the incidence, pathophysiology, and prognosis of gastric cancer(GC).AIM To analyze the differences in GC characteristics according to sex in patients who underwent surgical treatment for GC.METHODS A total of 2983 patients diagnosed with gastric adenocarcinoma who received surgical treatment at the Seoul National University Bundang Hospital between 2003 and 2017 were included.Baseline clinicopathological characteristics, histologic type of GC, overall and GC-specific survival rates, and associated risk factors were analyzed.RESULTS Among the 2983 patients, 2005(67.2%) and 978(32.8%) were males and females, respectively.The average age of the female group(59.36 years) was significantly younger than that of the male group(61.66 years;P < 0.001).Cancer of the gastric body(P < 0.001) and diffuse-type histology(P < 0.001) were more common in females than in males.This trend was more prominent in females younger than 60 years of age, with a significantly higher proportion of diffuse-type cancer than in the male group.Regardless of sex, diffuse-type GC was more common in younger patients, and the proportion of intestinal-type GC increased with age.The overall survival rate was significantly higher in females(P < 0.001).However, this difference disappeared for GC-specific survival(P = 0.168), except for the poor GC-specific survival rate in advanced-stage cancer(stage Ⅲ or above) in females(P = 0.045).The risk factors for GC-related mortality were older age, upper location of GC, and diffuse-or mixed-type histology.In terms of comorbidities, more males died from diseases other than GC, including other malignancies such as lung cancer, hepatocellular carcinoma, and pancreatic cancer, and respiratory diseases such as interstitial lung disease and chronic obstructive pulmonary disease, while there were relatively more cardiovascular or cerebrovascular deaths in females.CONCLUSION Sex-based differences in GC were observed in clinicopathological features, including age at diagnosis, tumor location, histologic type, survival rate, and comorbidities.

Sex-specific effects of Eugenia punicifolia extract on gastric ulcer healing in rats

AIM To evaluate the sex-specific effects of a hydroalcoholic extract from Eugenia punicifolia(HEEP) leaves on gastric ulcer healing.METHODS In this rat study involving males, intact(cycling) females, and ovariectomized females, gastric ulcers were induced using acetic acid. A vehicle, lansoprazole, or HEEP was administered for 14 d after ulcer induction. Body weight was monitored throughout the treatment period. At the end of treatment, the rats were euthanized and the following in vivo and in vitro investigations were performed: macroscopic examination of the lesion area and organ weights, biochemical analysis, zymography, and evaluation of protein expression levels. Additionally, the concentration-dependent effect of HEEP was evaluated in terms of subacute toxicity and cytotoxicity.RESULTS Compared to the vehicle, HEEP demonstrated a great healing capacity by substantially reducing the ulcerative lesion area in males(52.44%), intact females(85.22%), and ovariectomized females(65.47%), confirming that HEEP accelerates the healing of acetic acidinduced gastric lesions and suggesting that this effect is modulated by female sex hormones. The antiulcer effect of HEEP was mediated by prostaglandin E2 only in male rats. Overall, the beneficial effect of HEEP was the highest in intact females. Notably, HEEP promoted the expression of vascular endothelial growth factor(intact vs ovariectomized females) and decreased the expression of Caspase-8 and Bcl-2(intact female vs male or ovariectomized female). Additionally, HEEP enhanced fibroblast proliferation and migration into a wounded area in vitro, confirming its healing effect. Finally, no sign of subacute toxicity or cytotoxicity of HEEP was observed.CONCLUSION In gastric ulcers, HEEP-induced healing(modulated by female sex hormones; in males, mediated by prostaglandin) involves extracellular matrix remodeling, with gastric mucosa cell proliferation and migration.

Association between physiological responses after exercise at low altitude and acute mountain sickness upon ascent is sex-dependent

Background:Acute mountain sickness(AMS)is the mildest form of acute altitude illnesses,and consists of nonspecific symptoms when unacclimatized persons ascend to elevation of≥2500 m.Risk factors of AMS include:the altitude,individual susceptibility,ascending rate and degree of pre-acclimatization.In the current study,we examined whether physiological response at low altitude could predict the development of AMS.Methods:A total of 111 healthy adult healthy volunteers participated in this trial;and 99(67 men and 32 women)completed the entire study protocol.Subjects were asked to complete a 9-min exercise program using a mechanically braked bicycle ergometer at low altitude(500 m).Heart rate,blood pressure(BP)and pulse oxygen saturation(SpO2)were recorded prior to and during the last minute of exercise.The ascent from 500 m to 4100 m was completed in 2 days.AMS was defined as≥3 points in a 4-item Lake Louise Score,with at least one point from headache wat 6–8 h after the ascent.Results:Among the 99 assessable subjects,47(23 men and 24 women)developed AMS at 4100 m.In comparison to the subjects without AMS,those who developed AMS had lower proportion of men(48.9%vs.84.6%,P<0.001),height(168.4±5.9 cm vs.171.3±6.1 cm,P=0.019),weight(62.0±10.0 kg vs.66.7±8.6 kg,P=0.014)and proportion of smokers(23.4%vs.51.9%,P=0.004).Multivariate regression analysis revealed the following independent risks for AMS:female sex(odds ratio(OR)=6.32,P<0.001),SpO2 change upon exercise at low altitude(OR=0.63,P=0.002)and systolic BP change after the ascent(OR=0.96,P=0.029).Women had larger reduction in SpO2 after the ascent,higher AMS percentage and absolute AMS score.Larger reduction of SpO2 after exercise was associated with both AMS incidence(P=0.001)and AMS score(P<0.001)in men but not in women.Conclusions:Larger SpO2 reduction after exercise at low altitude was an independent risk for AMS upon ascent.Such an association was more robust in men than in women.Trial registration:Chinese Clinical Trial Registration,ChiCTR1900025728.Registered 6 September 2019.

Nonalcoholic fatty liver disease shows significant sex dimorphism

Nonalcoholic fatty liver disease(NAFLD),which has been renamed metabolic dysfunction-associated fatty liver disease,is a growing global medical problem.The incidence of NAFLD and its associated end-stage liver disease is increasing each year,and many research advancements have been achieved to date.This review focuses on the current knowledge of the sex differences in NAFLD and does not elaborate on areas without differences.Studies have revealed significant sex differences in the prevalence,influencing factors,pathophysiology,complications and therapies of NAFLD.Men have a higher incidence than women.Compared with women,men exhibit increased visceral fat deposition,are more susceptible to leptin resistance,lack estrogen receptors,and tend to synthesize fatty acids into fat storage.Male patients will experience more severe hepatic fibrosis and a higher incidence of liver cancer.However,once NAFLD occurs,women show a faster progression of liver fibrosis,higher levels of liver cell damage and inflammation and are less likely to undergo liver transplantation than men.In general,men have more risk factors and more severe pathophysiological reactions than women,whereas the development of NAFLD is faster in women,and the treatments for women are more limited than those for men.Thus,whether sex differences should be considered in the individualized prevention and treatment of NAFLD in the future is worth considering.

Sex-based differences in the prevalence of acute mountain sickness: a meta-analysis

Background:When lowlanders rapidly ascend to altitudes>2500 m,they may develop acute mountain sickness(AMS).The individual susceptibility,ascending velocity,time spent at altitude,activity levels and altitude reached are considered risk factors for AMS.However,it is not clear whether sex is a risk factor.The results have been inconclusive.We conducted a meta-analysis to test whether there were sex-based differences in the prevalence of AMS using Lake Louise Scoring System.Methods:Systematic searches were performed in August 2019 in EMBASE,PubMed,and Web of Science for prospective studies with AMS data for men and women.The titles and abstracts were independently checked in the primary screening step,and the selected full-text articles were independently assessed in the secondary screening step by the two authors(YPH and JLW)based on pre-defined inclusion criteria.The meta-analysis was performed using by the STATA 14.1 software program.A random-effects model was employed.Results:Eighteen eligible prospective studies were included.A total of 7669 participants(2639[34.4%]women)were tested.The results showed that there was a statistically significant higher prevalence rate of AMS in women than in men(RR=1.24,95%CI 1.09–1.41),regardless of age or race.However,the heterogeneity was significant in the analysis(Tau2=0.0403,Chi2=50.15,df=17;I2=66.1%,P=0.000),it was main caused by different numbers of subjects among the studies(coefficient=–2.17,P=0.049).Besides,the results showed that there was no evidence of significant publication bias in the combined studies on the basis of Egger’s test(bias coefficient=1.48,P=0.052)and Begg’s test(P=0.130).Conclusions:According to this study,the statistically significant finding emerging from this study was that women have a higher prevalence of AMS.However,the authors could not exclude studies where patients were on acetazolamide.Our analysis provided a direction for future studies of the relationship of sex and the risk of AMS,such as the pathological mechanism and prevention research.

Mediation Effects of Placental Inflammatory Transcriptional Biomarkers on the Sex-Dependent Associations between Maternal Phthalate Exposure and Infant Allergic Rhinitis: A Population-Based Cohort Study

Objective Prenatal phthalate exposure has been associated with placental inflammatory factors and infant allergic rhinitis(AR).However,the results are inconclusive.We designed a population-based cohort study to examine the effects of placental inflammatory biomarkers on the sex-dependent associations between maternal phthalate exposure and infant AR.Methods A total of 2,348 pregnant women from Ma’anshan,Anhui Province,China,who were screened before antenatal visits and met the inclusion criteria,were included in the present study.We assessed AR in their offspring aged 36 months with a questionnaire.Quantitative PCR was performed to measure placental inflammatory factor m RNAs.The independent samples t-test and multivariable logistic regression were used to determine the associations between infant AR and maternal phthalates.Results Childhood AR may be related to education and family monthly income(P = 0.01).The phthalate metabolites,mono(2-ethylhexyl) phthalate(MEHP),mono(2-ethyl-5-hydroxyl) phthalate(MEHHP),in pregnant women were associated with a significantly increased risk for infant AR in males[P < 0.05;odds ratio(OR):1.285;95% confidence interval(CI):1.037-1.591,and OR:1.232,95% CI:1.008-1.507,respectively],but not females.Additionally,irritably-increased expression levels of HO-1 and IL-4 were associated with AR in male infants(OR:1.175;95% CI:1.038-1.329 and OR:1.181;95% CI:1.056-1.322,respectively).The association between maternal urinary MEHHP and placental HO-1 was marginally significant according to mediation analysis.Conclusion The associations of maternal MEHHP and MEOHP levels with fetal AR in males were significant.Placental HO-1 was a fractional mediator in the associations between MEHHP and AR.Thus,the placenta should be further investigated as a potential mediator of maternal exposure-induced disease risk in children.