Sex-based differences in clinical and radiological presentation of patients with degenerative lumbar scoliosis: a cross-sectional study

BACKGROUND

To evaluate the sex-based differences in clinical and radiological presentation of patients with degenerative lumbar scoliosis (DLS) and to explore whether the difference is helpful in investigating the etiology and progression of DLS.

METHOD

A retrospective review of 199 patients (41 males, 158 females) with DLS was included. Patient demographics including age, gender, bone mineral density were collected. Back and leg pain was assessed by visual analog scale, and general physical condition was assessed by Oswestry Disability Index. Cobb's angle was measured, and direction of scoliosis, position of the superior, inferior and apex vertebrae, number of vertebrae included in the scoliosis, rotation of apex vertebrae (Nash-Mo index), translation of apex vertebrae were recorded. Sagittal longitudinal axis, thoracolumbar kyphosis, lumbar lordosis (LL), pelvic incidence angle (PI), sacral slope, apex of lumbar lordosis and coronal balance distance were measured by whole spine lateral radiographs, and type of coronal imbalance was evaluated in all patients. Fat infiltration rate (FIR) of the paraspinal muscles at the vertebral apex was measured by MRI.

RESULT

Compared to female patients, male patients showed more back and leg pain on clinical presentation and smaller Cobb angle, less parietal rotation, larger LL, smaller PI-LL and lower paravertebral muscle FIR on radiologic features.

CONCLUSION

Gender differences do exist in DLS patients with regard to clinical and radiological presentation, low back pain was more pronounced in male patients, and scoliosis was more severe in female patients based on this cross-sectional study.

Cigarette smoking affects the differences between male and female phenotypes

BACKGROUND

Sex-gender medicine focuses on differences and similarities in health and disease between men and women. The present study focused on the existence of male and female phenotypes when routine demographic, biochemical and haematological data are considered and aimed to determine the influence of smoking on phenotypes and evaluate the role of body weight on sex-gender differences in view of the fact that some of them can be utilized as biomarkers of diagnosis, diseases and therapeutic response.

METHODS

Eighty-five healthy young adult men (27 smokers and 58 non-smokers) and 85 women (32 smokers and 53 non-smokers) well matched for age were enrolled. 31 haematochemical parameters were measured and data were analysed before and after normalization for body weight applying the two-way analysis of variance and principal component analysis (PCA).

RESULTS

In non-smoking cohorts, there were numerous sex-gender differences and PCA analysis distinguished two different phenotypes: males and females. Body weight normalization induced qualitatively and quantitatively changes, but male and female phenotypes were still well evident. Smoking influenced numerous parameters and PCA analysis evidenced that these changes led to the abolition of male and female phenotypes.

CONCLUSIONS

Personalized medicine has the goals to study modification of markers profile in the single individual, which is strongly influenced by sex-gender and smoking habit. In non-smokers, male and female phenotypes are present independently from the quantitation method used. In smokers only one phenotype is present. These results suggest that smoking and sex-gender should be considered as an independent variable in clinical research.

Sex-gender-related therapeutic approaches for cardiovascular complications associated with diabetes

Diabetes is a chronic disease associated with micro- and macrovascular complications and is a well-established risk factor for cardiovascular disease. Cardiovascular complications associated with diabetes are among the most important causes of death in diabetic patients. Interestingly, several sex-gender differences have been reported to significantly impact in the pathophysiology of diabetes. In particular, sex-gender differences have been reported to affect diabetes epidemiology, risk factors, as well as cardiovascular complications associated with diabetes. This suggests that different therapeutic approaches are needed for managing diabetes-associated cardiovascular complications in men and women. In this review, we will discuss about the sex-gender differences that are known to impact on diabetes, mainly focusing on the cardiovascular complications associated with the disease. We will then discuss the therapeutic approaches for managing diabetes-associated cardiovascular complications and how differences in sex-gender can influence the existing therapeutic approaches.