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Pelzner K, Fuchs C, Petersen M, Maus M, Bruns CJ, Leers JM. Sex- and gender-specific differences in symptoms and health-related quality of life among patients with gastroesophageal reflux disease. Dis Esophagus 2024; 37:doad064. [PMID: 37963417 DOI: 10.1093/dote/doad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/01/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Gastroesophageal Reflux Disease (GERD) is a common chronic gastrointestinal disorder affecting both men and women. Nonerosive reflux disease generally affects more women, whereas GERD complications such as Barrett's esophagus (BE) or esophageal cancer affect more men. The aim of this study was to evaluate sex- and gender-specific symptoms and health-related quality of life (HRQoL) among men and women with GERD. Patients with clinical signs of reflux and completion of 24-hour pH-Impedance testing at the University Hospital Cologne were included into the study. Evaluation of symptoms and HRQoL included the following validated questionnaires: GERD-Health-Related Quality of Life (GERD HRQL), Gastrointestinal Quality of Life Index (GIQLI), and Hospital Anxiety and Depression Scale (HADS). In all, 509 women and 355 men with GERD were included. Men had a significantly higher DeMeester score (60.2 ± 62.6 vs. 43 ± 49.3, P < 0.001) and a higher incidence of BE (18.6 vs. 11.2%, P = 0.006). Women demonstrated significantly higher levels of anxiety (30.9 vs. 14.5%, P = 0.001), more severely impacting symptoms (45.3 ± 11.3 vs. 49.9 ± 12.3, P < 0.001), as well as physical (14.2 ± 5.7 vs. 16.7 ± 5.6, P < 0.001) and social dysfunction (13.3 ± 4.8 vs. 14.8 ± 4.3, P = 0.002). Women further reported a lower HRQoL (85.3 ± 22.7 vs. 92.9 ± 20.8, P < 0.001). Men and women differ on biological, psychological, and sociocultural levels.
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Affiliation(s)
- Kim Pelzner
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Claudia Fuchs
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Matti Petersen
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Martin Maus
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
| | - Christiane J Bruns
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - Jessica M Leers
- Department of Functional Upper GI Surgery, Evangelical Hospital Kalk, Cologne, Germany
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
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Brady B, Zheng L, Kootar S, Anstey KJ. Sex and gender differences in risk scores for dementia and Alzheimer's disease among cisgender, transgender, and non-binary adults. Alzheimers Dement 2024; 20:5-15. [PMID: 37493177 PMCID: PMC10916956 DOI: 10.1002/alz.13317] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/25/2023] [Accepted: 05/11/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Few studies have explored dementia risk according to sex and gender including for transgender and non-binary adults. This study evaluated dementia risk factors and risk scores among cisgender, transgender, and non-binary adults. METHODS Observational data were drawn from the 2019 Behavioral Risk Factor Surveillance System. A matched-cohort approach was used to develop sex (male, female) and gender identity cohorts (cisgender men, cisgender women, transgender men, transgender women, and non-binary adults) for comparison. Dementia risk scores were calculated using established mid-life and late-life risk score algorithms. RESULTS Males had higher overall mid-life dementia risk, and lower late-life Alzheimer's disease risk compared to females. Transgender men, transgender women, and non-binary adults had higher overall late-life risk compared to both cisgender men and women. DISCUSSION Future research is needed to build the evidence base for specific risk factors that may be contributing to higher overall risk among understudied and underserved gender groups. HIGHLIGHTS Using data from the 2019 Behavioral Risk Factor Surveillance System, this matched-cohort study found that those assigned female at birth had lower overall mid-life dementia risk and higher overall late-life Alzheimer's disease (AD) risk compared to those assigned male at birth. Transgender men, transgender women, and non-binary adults all showed higher overall late-life AD risk compared to cisgender men and cisgender women. Between-group differences were found in the incidence of specific risk and protective factors for dementia and AD.
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Affiliation(s)
- Brooke Brady
- School of PsychologyThe University of New South Wales SydneyKensingtonNew South WalesAustralia
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- UNSW Ageing Futures InstituteUNSW SydneyKensingtonNew South WalesAustralia
| | - Lidan Zheng
- School of PsychologyThe University of New South Wales SydneyKensingtonNew South WalesAustralia
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- UNSW Ageing Futures InstituteUNSW SydneyKensingtonNew South WalesAustralia
| | - Scherazad Kootar
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- UNSW Ageing Futures InstituteUNSW SydneyKensingtonNew South WalesAustralia
| | - Kaarin Jane Anstey
- School of PsychologyThe University of New South Wales SydneyKensingtonNew South WalesAustralia
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- UNSW Ageing Futures InstituteUNSW SydneyKensingtonNew South WalesAustralia
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Graf J, Simoes E, Kranz A, Weinert K, Abele H. The Importance of Gender-Sensitive Health Care in the Context of Pain, Emergency and Vaccination: A Narrative Review. Int J Environ Res Public Health 2023; 21:13. [PMID: 38276801 PMCID: PMC10815689 DOI: 10.3390/ijerph21010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
So far, health care has been insufficiently organized in a gender-sensitive way, which makes the promotion of care that meets the needs of women and men equally emerge as a relevant public health problem. The aim of this narrative review was to outline the need for more gender-sensitive medical care in the context of pain, emergency care and vaccinations. In this narrative review, a selective search was performed in Pubmed, and the databases of the World Health Organization (WHO), the European Institute for Gender Equality and the German Federal Ministry of Health were searched. Study data indicate that there are differences between men and women with regard to the ability to bear pain. On the other hand, socially constructed role expectations in pain and the communication of these are also relevant. Studies indicate that women receive adequate pain medication less often than men with a comparable pain score. Furthermore, study results indicate that the female gender is associated with an increased risk of inadequate emergency care. In terms of vaccine provision, women are less likely than men to utilize or gain access to vaccination services, and there are gender-sensitive differences in vaccine efficacy and safety. Sensitization in teaching, research and care is needed to mitigate gender-specific health inequalities.
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Affiliation(s)
- Joachim Graf
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
| | - Elisabeth Simoes
- Department for Women’s Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Angela Kranz
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
| | - Konstanze Weinert
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
| | - Harald Abele
- Institute for Health Sciences, University Hospital Tuebingen, Midwifery Science, Hoppe-Seyler-Str. 9, 72076 Tuebingen, Germany; (A.K.); (K.W.); (H.A.)
- Department for Women’s Health, University Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
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Dolce A, Della Torre S. Sex, Nutrition, and NAFLD: Relevance of Environmental Pollution. Nutrients 2023; 15:nu15102335. [PMID: 37242221 DOI: 10.3390/nu15102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease and represents an increasing public health issue given the limited treatment options and its association with several other metabolic and inflammatory disorders. The epidemic, still growing prevalence of NAFLD worldwide cannot be merely explained by changes in diet and lifestyle that occurred in the last few decades, nor from their association with genetic and epigenetic risk factors. It is conceivable that environmental pollutants, which act as endocrine and metabolic disruptors, may contribute to the spreading of this pathology due to their ability to enter the food chain and be ingested through contaminated food and water. Given the strict interplay between nutrients and the regulation of hepatic metabolism and reproductive functions in females, pollutant-induced metabolic dysfunctions may be of particular relevance for the female liver, dampening sex differences in NAFLD prevalence. Dietary intake of environmental pollutants can be particularly detrimental during gestation, when endocrine-disrupting chemicals may interfere with the programming of liver metabolism, accounting for the developmental origin of NAFLD in offspring. This review summarizes cause-effect evidence between environmental pollutants and increased incidence of NAFLD and emphasizes the need for further studies in this field.
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Affiliation(s)
- Arianna Dolce
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy
| | - Sara Della Torre
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy
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Friedrichs K, Kellmeyer P. Neurofeminism: Feminist critiques of research on sex/gender differences in the neurosciences. Eur J Neurosci 2022; 56:5987-6002. [PMID: 36180041 DOI: 10.1111/ejn.15834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 12/29/2022]
Abstract
Over the last three decades, the human brain and its role in determining behavior have been receiving a growing amount of attention in academia as well as in society more generally. Neuroscientific explanations of human behavior or other phenomena are often especially appealing to lay people. Therefore, neuroscientific explanations that can affect individuals, groups, or social relations in general should be formulated in a careful and responsible way. One field in which especially feminist scholars request more caution is the neuroscientific examination of sex/gender differences. Feminist scholars have described various ways in which sexist bias might be present in neuroscientific research on sex/gender differences. In this context, they coined the term "neurosexism" to describe the entanglement between neuroscientific work and sexist ideology, and "neurofeminism" as a response to that. Here, we aim to give an overview over the contemporary neurofeminist literature. In the first part, common levels of analysis in the neurofeminist literature are presented and the research level is explored in more detail. In the second part, some common developments in more recent neurofeminist scholarship are discussed. For this, we review recent publications with the aim to provide neuroscientists with a solid understanding of neurofeminist criticism so that they may evaluate neuroscientific claims about on sex/gender differences from this critical perspective.
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Affiliation(s)
- Kassandra Friedrichs
- University College Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
| | - Philipp Kellmeyer
- Human-Technology Interaction Lab, Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany.,Freiburg Institute for Advanced Studies, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
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Gartner C, Bickl A, Härtl S, Loy JK, Häffner L. Differences in problem and pathological gambling: A narrative review considering sex and gender. J Behav Addict 2022; 11:267-289. [PMID: 35499928 PMCID: PMC9295224 DOI: 10.1556/2006.2022.00019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/11/2022] [Accepted: 03/22/2022] [Indexed: 12/05/2022] Open
Abstract
Background and aim A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted. Methods We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey. Results We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives). Discussion and conclusion To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.
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Affiliation(s)
- Corinna Gartner
- BAS Bayerische Akademie für Sucht- und Gesundheitsfragen (Unternehmergesellschaft haftungsbeschränkt), LSG Landesstelle Glücksspielsucht in Bayern, Munich, Germany
| | | | - Sabine Härtl
- BAS Bayerische Akademie für Sucht- und Gesundheitsfragen (Unternehmergesellschaft haftungsbeschränkt), LSG Landesstelle Glücksspielsucht in Bayern, Munich, Germany
| | | | - Laura Häffner
- BAS Bayerische Akademie für Sucht- und Gesundheitsfragen (Unternehmergesellschaft haftungsbeschränkt), LSG Landesstelle Glücksspielsucht in Bayern, Munich, Germany
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Abdel Malek GS, Goudriaan AE, Kaag AM. The relationship between craving and insular morphometry in regular cocaine users: Does sex matter? Addict Biol 2022; 27:e13157. [PMID: 35229953 PMCID: PMC9286054 DOI: 10.1111/adb.13157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 12/01/2022]
Abstract
While it has been suggested that cocaine use and relapse in women is more strongly related to stress‐relief craving, whereas cocaine use in men is more strongly related to reward craving, the neural mechanisms that underlie these differences are poorly understood. The aim of this study was to investigate sex‐dependent differences in insular morphometry and associations with craving, in a sample of regular cocaine users (CUs) and non‐drug using controls (non‐CUs). It was hypothesized that insular volume, thickness and surface area would be lower in CU women, compared with CU men and non‐CUs. It was furthermore hypothesized that insular morphometry, particularly insular thickness, would be negatively associated to reward craving in CU men, while being negatively associated with stress‐relief craving in CU women. In contrast to the hypothesis, we did not find evidence of sex‐specific differences in insular morphometry in CUs. However, sex‐specific association between stress‐relief craving and insular morphometry were found: Right insular volume was negatively associated with stress‐relief craving in CU women, whereas this association was positive in CU men. Additionally, right insular surface area was negatively associated with stress‐relief craving in cocaine‐using men, whereas this association was positive in cocaine‐using women. In conclusion, the current study provides first evidence of sex‐specific differences in the association between craving and insular morphometry in a sample of regular cocaine users. Although speculative, these sex‐specific alterations in insular morphometry may underlie higher stress‐induced craving and relapse in CU women compared with CU men.
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Affiliation(s)
- George S. Abdel Malek
- Department of Clinical, Neuro and Developmental Psychology Vrije University Amsterdam Amsterdam The Netherlands
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands
- Arkin Mental Health and Jellinek Amsterdam The Netherlands
- Amsterdam Institute for Addiction Research Amsterdam The Netherlands
| | - Anne Marije Kaag
- Department of Clinical, Neuro and Developmental Psychology Vrije University Amsterdam Amsterdam The Netherlands
- The Amsterdam Brain and Cognition Center (ABC) University of Amsterdam Amsterdam The Netherlands
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Kennedy S. Frontiers in Global Women's Health: Choose to Challenge. Front Glob Womens Health 2021; 2:676178. [PMID: 34816228 PMCID: PMC8593995 DOI: 10.3389/fgwh.2021.676178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/28/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Stephen Kennedy
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
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Abstract
Non-alcoholic fatty liver disease (NAFLD) is a major health issue worldwide, being frequently associated with obesity, unbalanced dietary regimens, and reduced physical activity. Despite their greater adiposity and reduced physical activity, women show a lower risk of developing NAFLD in comparison to men, likely a consequence of a sex-specific regulation of liver metabolism. In the liver, sex differences in the uptake, synthesis, oxidation, deposition, and mobilization of lipids, as well as in the regulation of inflammation, are associated with differences in NAFLD prevalence and progression between men and women. Given the major role of sex hormones in driving hepatic sexual dimorphism, this review will focus on the role of sex hormones and their signaling in the regulation of hepatic metabolism and in the molecular mechanisms triggering NAFLD development and progression.
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Affiliation(s)
- Sara Della Torre
- Department of Pharmaceutical Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
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