Sex-Specific Effects of Polystyrene Microplastic and Lead(II) Co-Exposure on the Gut Microbiome and Fecal Metabolome in C57BL/6 Mice

The wide spread of microplastics has fueled growing public health concern globally. Due to their porous structure and large surface area, microplastics can serve as carriers for other environmental pollutants, including heavy metals. Although the toxic effects of microplastics or heavy metals have been reported previously, investigations into the sex-differential health effects of combined exposure to microplastics and heavy metals are lacking. In the present study, the effects of polystyrene microplastics and lead(II) co-exposure on the gut microbiome, intestinal permeability, and fecal metabolome were examined in both male and female mice. Combined exposure of polystyrene microplastics and lead(II) increased intestinal permeability in both male and female mice. Sex-specific responses to the co-exposure were found in gut bacteria, fungi, microbial metabolic pathways, microbial genes encoding antibiotic resistance and virulence factors, as well as fecal metabolic profiles. In particular, Shannon and Simpson indices of gut bacteria were reduced by the co-exposure only in female mice. A total of 34 and 13 fecal metabolites were altered in the co-exposure group in female and male mice, respectively, among which only three metabolites were shared by both sexes. These sex-specific responses to the co-exposure need to be taken into consideration when investigating the combined toxic effects of microplastics and heavy metals on the gut microbiota.

Higher conversion rate to knee arthroplasty in female patients following medial open-wedge high tibial osteotomy

PURPOSE

Most studies about medial open-wedge high tibial osteotomy (HTO) reported outcomes without focusing on gender differences. Therefore, the study compared the long-term survival rate and postoperative subjective knee function after HTO in female versus male patients with symptomatic medial compartment knee osteoarthritis.

METHODS

The data of three cohorts with long-term outcomes were analysed (n = 245; 32% females; age: 49 ± 7 years; Kellgren Lawrence Grade I 6.1%, II 32.7%, III 42.4%; IV 18.8%). The minimum follow-up was at least 6 years or an earlier conversion to total knee arthroplasty (TKA). The gender-specific survival rate after HTO was calculated after 5 and 10 years and compared using Kaplan-Meier analysis and the logrank test. Baseline characteristics and subjective knee function (International Knee Documentation Committee [IKDC]/Lysholm) were analysed between both genders.

RESULTS

Forty of 78 (51.3%) women and 41 of 167 men (24.5%) underwent TKA. HTO survival in females was significantly lower (p = 0.0010). The 5- and 10-year survival rates were 85.9% and 62.6% for females and 93.4% and 77.7% for males. In females and males, from preoperative to the last follow-up, the IKDC (43 ± 15 to 58 ± 17; 47 ± 14 to 67 ± 18) and the Lysholm (42 ± 18 to 72 ± 18; 55 ± 22 to 77 ± 23) improved significantly (all p < 0.0001). Females had significantly lower preoperative and postoperative IKDC (p = 0.0438; p = 0.0035) and Lysholm scores (p = 0.0002; p = 0.0323). But the absolute improvements of the IKDC and Lysholm were not significantly different between genders.

CONCLUSIONS

Females had higher conversion rates to TKA and lower knee function at the last follow-up. However, preoperative knee function was lower in females and the absolute improvement following HTO was similar for both genders. In general, females benefit from HTO to treat medial knee arthritis, and TKA could be postponed for half of female patients for more than 10 years. However, surgeons must be aware of the described inferior outcomes in females for realistic patient expectation management.

LEVEL OF EVIDENCE

Level II.

Association of Uroguanylin, Body Mass Index, and Waist Circumference: Sex Differences and Obesity Implications among a Sample of Iraqi Adults in Baghdad City

This research investigates the gender-specific associations of uroguanylin levels with various health-related parameters in Iraqi adults. The results revealed significant differences between genders in food style preferences and waist circumference (WC) risk. Notably, uroguanylin exhibited distinct correlations with low density lipoprotein (LDL) cholesterol, glycated hemoglobin (HbA1c), body mass index (BMI), and WC in females and males, indicating potential gender-specific effects on lipid metabolism, glucose regulation, and adiposity. A total of 140 Iraqi adults (73 females and 67 males) were recruited into the study. Physical activity levels, food style preferences, WC risk, and BMI subgroups, were compared between genders. Additionally, participants' characteristics, including age, height, weight, BMI, blood pressure, cholesterol levels, and uroguanylin concentrations, were analyzed. Significant gender differences were observed in food style preferences, with a higher proportion of males preferring fast food, with a greater percentage of females classified as having a high risk, females exhibited lower height and weight compared to males. HbA1c levels were significantly lower in females, whereas high density lipoprotein (HDL) cholesterol levels were significantly higher in females than in males. Uroguanylin concentrations were also significantly lower in females compared to males. Uroguanylin shows a moderately negative correlation with LDL cholesterol in females but not in males. Furthermore, a strong negative association between uroguanylin and HbA1c in females indicated improved glycemic control with higher uroguanylin levels, whereas an opposite trend was observed in males. No significant association was observed between uroguanylin and BMI in females, a significant positive correlation was found in males. For WC, a weak negative correlation was noted in females, whereas a moderately negative correlation was observed in males. These contrasting correlations imply potential gender-specific effects of uroguanylin on adiposity and body fat distribution.

Physical Mobility, Social Isolation and Cognitive Function: Are There Really Gender Differences?

OBJECTIVE

This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults.

METHODS

This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults.

RESULTS

The total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific.

CONCLUSION

This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.

Age-specific risk factors for the prediction of obesity using a machine learning approach

Machine Learning is a powerful tool to discover hidden information and relationships in various data-driven research fields. Obesity is an extremely complex topic, involving biological, physiological, psychological, and environmental factors. One successful approach to the topic is machine learning frameworks, which can reveal complex and essential risk factors of obesity. Over the last two decades, the obese population (BMI of above 23) in Korea has grown. The purpose of this study is to identify risk factors that predict obesity using machine learning classifiers and identify the algorithm with the best accuracy among classifiers used for obesity prediction. This work will allow people to assess obesity risk from blood tests and blood pressure data based on the KNHANES, which used data constructed by the annual survey. Our data include a total of 21,100 participants (male 10,000 and female 11,100). We assess obesity prediction by utilizing six machine learning algorithms. We explore age- and gender-specific risk factors of obesity for adults (19-79 years old). Our results highlight the four most significant features in all age-gender groups for predicting obesity: triglycerides, ALT (SGPT), glycated hemoglobin, and uric acid. Our findings show that the risk factors for obesity are sensitive to age and gender under different machine learning algorithms. Performance is highest for the 19-39 age group of both genders, with over 70% accuracy and AUC, while the 60-79 age group shows around 65% accuracy and AUC. For the 40-59 age groups, the proposed algorithm achieved over 70% in AUC, but for the female participants, it achieved lower than 70% accuracy. For all classifiers and age groups, there is no big difference in the accuracy ratio when the number of features is more than six; however, the accuracy ratio decreased in the female 19-39 age group.

The gender-specific bidirectional relations between chronic diseases and total bilirubin/urea in the elderly population: A 3-year longitudinal study

Aging is accompanied by changes in physiology over time, which remains the largest risk of chronic diseases. The aim of this study was to explore the gender-specific bidirectional relations between the risk of chronic diseases and serum traits in a 3-year longitudinal study. A hierarchical non-linear model with random effects was used to assess the temporal patterns of anthropometric and serum traits from 2017 to 2019 among 2,338 participants. To assess the directional effect between the risk of chronic diseases and serum traits, a bivariate cross-lagged panel model (CLPM) was used to estimate the structural relations of repeatedly measured variables at three different time points. Candidate SNPs were analyzed and genotyped in MassARRAY Analyzer 4 platforms. In this study, metabolic syndrome (MS) score increased with aging in females, whereas the fatty liver disease (FLD) index decreased with aging in males; the MS score was negatively correlated with TB in females, and FLD index was positively related to urea in males; CLPM showed that the MS score predicted total bilirubin (TB) in females, and urea predicted the FLD index in males. Additionally, rs2292354 in G protein-coupled receptor kinase interactor 2 (GIT2) was associated with the MS score and TB in aged females. Our study suggests the potential gender-specific causal associations between development in MS and increase in TB level in females, and rise in urea level and improved FLD index in males. The SNP rs2292354 we investigated might be a biomarker for predicting MS in the elderly Chinese Han population.

Gender differences contribute to variability of serum lipid biomarkers for Alzheimer's disease

Background: Alzheimer's disease (AD) cannot currently be diagnosed by a blood test. One reason may be gender differences. Another may be the statistical methods used. The authors evaluate these possibilities. Objective: The authors applied serum lipidomics to find AD biomarkers in men and women. They hypothesized that AD biomarkers would differ between genders and that machine-learning algorithms would improve diagnostic performance. Methods: Serum lipids were analyzed by mass spectrometry for a training set of AD cases and controls and in a blinded test set. Statistical analyses considered gender differences. Results: Lipids best classifying AD subjects differed significantly between men and women. Robust statistical algorithms did not improve diagnostic performance. Conclusion: Poor performance of AD biomarkers appears to be due primarily to inherent variability in AD patients.

Gender-Inclusive and Gender-Specific Approaches in Trans Health Research

The recent proliferation of trans health literature for the past 20 years has prompted a need to examine two contested approaches used in designing study protocols and analyses in trans health research, as either specific to only one gender group (gender-specific approach) or across gender groups (i.e., gender-inclusive approach). In this critique, we aim to explicate and provide guidance for when the application of each approach is methodologically appropriate.

Gender-Specific Association Between Sleep Duration and Body Mass Index in Rural China

BACKGROUND

This study aimed at investigating the association of sleep duration with body mass index (BMI) by gender among adult residents in rural Hanzhong of Shaanxi province, Northwest China.

METHODS

A two-level stratified random cluster sampling method was used to select adult residents between the ages of 18 and 80 years. All information including sociodemographic characteristics and lifestyles was collected by face-to-face interview with a structured questionnaire. According to standard methods, trained staff were responsible for anthropometric measurements using calibrated instruments in an empty room. By gender, both ordinary least square regression (OLS) and quantile regression (QR) were used to analyze the relationship between sleep time and BMI controlling for other confounders. The restricted cubic splines with five knots were further used to express the potentially non-linear association between sleep time and BMI.

RESULTS

A total of 3,017 eligible participants were included in the study. After controlling for confounding factors including sociodemographic characteristics and lifestyles, OLS regression did not indicate any significant association of sleep duration with BMI among men and women. Among men, it was clear that there is an inverse U-shaped relationship between sleep time and BMI beyond the 66.0th percentile (BMI ≥24). Among women, quantile regression presented a significant U-shaped relationship between BMI and sleep duration. According to the restricted cubic splines, the women who sleep for approximately 9 h had the lowest BMI, and when sleep duration approached approximately 7 h among men, their BMI would be the highest.

CONCLUSIONS

The U-shaped and inverse U-shaped relationships between sleep duration and BMI were clearly observed for women and men, respectively, in our study. The identification of potentially relevant modifiable risk factors may provide better preventive approaches to obesity.

Erythropoietin Non-hematopoietic Tissue Response and Regulation of Metabolism During Diet Induced Obesity

Erythropoietin (EPO) receptor (EPOR) determines EPO response. High level EPOR on erythroid progenitor cells gives rise to EPO regulated production of red blood cells. Animal models provide evidence for EPO activity in non-hematopoietic tissue mediated by EPOR expression. Beyond erythropoiesis, EPO activity includes neuroprotection in brain ischemia and trauma, endothelial nitric oxide production and cardioprotection, skeletal muscle wound healing, and context dependent bone remodeling affecting bone repair or bone loss. This review highlights examples of EPO protective activity in select non-hematopoietic tissue with emphasis on metabolic response mediated by EPOR expression in fat and brain and sex-specific regulation of fat mass and inflammation associated with diet induced obesity. Endogenous EPO maintains glucose and insulin tolerance and protects against fat mass accumulation and inflammation. Accompanying the increase in erythropoiesis with EPO treatment is improved glucose tolerance and insulin response. During high fat diet feeding, EPO also decreases fat mass accumulation in male mice. The increased white adipose tissue inflammation and macrophage infiltration associated with diet induced obesity are also reduced with EPO treatment with a shift toward an anti-inflammatory state and decreased inflammatory cytokine production. In female mice the protective effect of estrogen against obesity supersedes EPO regulation of fat mass and inflammation, and requires estrogen receptor alpha activity. In brain, EPOR expression in the hypothalamus localizes to proopiomelanocortin neurons in the arcuate nucleus that promotes a lean phenotype. EPO stimulation of proopiomelanocortin neurons increases STAT3 signaling and production of proopiomelanocortin. Cerebral EPO contributes to metabolic response, and elevated brain EPO reduces fat mass and hypothalamus inflammation during diet induced obesity in male mice without affecting EPO stimulated erythropoiesis. Ovariectomy abrogates the sex-specific metabolic response of brain EPO. The sex-dimorphic EPO metabolic response associated with fat mass accumulation and inflammation during diet induced obesity provide evidence for crosstalk between estrogen and EPO in their anti-obesity potential in female mice mediated in part via tissue specific response in brain and white adipose tissue. Endogenous and exogenous EPO response in non-hematopoietic tissue demonstrated in animal models suggests additional activity by which EPO treatment may affect human health beyond increased erythropoiesis.

Benefits of Digital Health Resources for Substance Use Concerns in Women: Scoping Review

BACKGROUND

Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Indeed, both sex- and gender-specific approaches are critical to improve health and gender equity. Violence and trauma are frequent among those with substance use concerns, but they disproportionately affect those who identify as female or women, further underscoring the need for trauma-informed care as well.

OBJECTIVE

The objective of this investigation was to evaluate the evidence supporting the efficacy or effectiveness of online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma.

METHODS

This scoping review is based on an academic search in MEDLINE, APA PsycINFO, Embase, Cochrane Central, and CINAHL, as well as a grey literature search in US and Canadian government and funding agency websites. Of the 7807 records identified, 465 remained following title and abstract screening. Of these, 159 met all eligibility criteria and were reviewed and synthesized.

RESULTS

The 159 records reflected 141 distinct studies and 125 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Evaluated digital health resources included multisession and brief-session interventions, with a wide range of therapeutic elements. Multisession online and mobile interventions exhibited beneficial effects in 86.1% (105/122) of studies. Single-session interventions similarly demonstrated beneficial effects in 64.2% (43/67) of study conditions. Most investigations did not assess gender identity or conduct sex- or gender-based analyses. Only 13 investigations that included trauma were identified.

CONCLUSIONS

Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence on the efficacy or effectiveness of interventions in females or women specifically is weak.

Plasmodium transcription repressor AP2-O3 regulates sex-specific identity of gene expression in female gametocytes

Male and female gametocytes are sexual precursor cells essential for mosquito transmission of malaria parasite. Differentiation of gametocytes into fertile gametes (known as gametogenesis) relies on the gender‐specific transcription program. How the parasites establish distinct repertoires of transcription in the male and female gametocytes remains largely unknown. Here, we report that an Apetala2 family transcription factor AP2‐O3 operates as a transcription repressor in the female gametocytes. AP2‐O3 is specifically expressed in the female gametocytes. AP2‐O3‐deficient parasites produce apparently normal female gametocytes. Nevertheless, these gametocytes fail to differentiate into fully fertile female gametes, leading to developmental arrest in fertilization and early development post‐fertilization. AP2‐O3 disruption causes massive upregulation of transcriptionally dormant male genes and simultaneously downregulation of highly transcribed female genes in the female gametocytes. AP2‐O3 targets a substantial proportion of the male genes by recognizing an 8‐base DNA motif. In addition, the maternal AP2‐O3 is removed after fertilization, which is required for the zygote to ookinete development. Therefore, the global transcriptional repression of the male genes in the female gametocytes is required for safeguarding female‐specific transcriptome and essential for the mosquito transmission of Plasmodium.

Gender-Specific Inverse Associations Between Beans Intake, Serum Urate Levels, and Hyperuricemia: A Cross-Sectional Analysis Based on the Henan Rural Cohort Study

Background and Aims: Beans are rich in purines, which are important substances that lead to elevated serum urate, especially exogenous purines. Few studies were conducted to assess the relationship between beans intake and serum urate or hyperuricemia, especially in rural people. The purpose of this study was to validate the association by gender in the rural Chinese population.

Methods: A total of 38,855 participants aged 18–79 years old were enrolled from the Henan Rural Cohort Study (Registration number: ChiCTR-OOC-15006699). Dietary data were collected using a validated food frequency questionnaire (FFQ). Linear regression models and logistic regression models were used to examine the associations between beans intake and serum urate levels or hyperuricemia. Restricted cubic spline regression was performed to display the dose–response relationship.

Results: In multivariate-adjusted linear regression, an inverse correlation was found between beans intake and serum urate level (the highest quartile Q4 vs. the bottom quartile Q1) in both men (P = 0.008) and women (P < 0.001). Per 10-g increment in beans intake was associated with 0.30 μmol/L decreased concentration of serum urate in men and 0.71 μmol/L in women. The multivariate-adjusted odds ratios (ORs) of hyperuricemia were 0.83 (0.71, 0.97) in men and 0.73 (0.63, 0.84) in women (Q4 vs. Q1). Per 10-g increment in beans intake created a 1% decreased risk of hyperuricemia in men and 3% in women. The cubic spline suggested a risk reduction for hyperuricemia with increasing intake of beans.

Conclusion: A higher beans intake was associated with a lower serum urate level and a reduced risk of hyperuricemia in both sexes, and the association was more pronounced in women.

Gender-related sociocultural differences and COVID-19: what influence on the effects of the pandemic?

In the first stages of the pandemic, the adverse outcomes of COVID-19 were significantly higher in men than in women most likely as the effect of biological, hormonal, metabolic differences between the two sexes. However, gender-related differences in lifestyles and social roles can also greatly influence the course of disease. To fully understand the influence of gender in the COVID-19 outbreak, the collection and dissemination of disaggregated data must be enhanced to allow a better knowledge of the effects of SARS-CoV-2 infection in men and women, not only from a biomedical point of view, but also considering the risk factors associated with the different roles that they play in the society.

A Short-Term Longitudinal Investigation of the Perceived Hookup Attitude of Gender-Specific Close Friends and Hookup Behavior

Research suggests that peer injunctive norms (i.e., perceived attitudes) have an indirect effect on youth’s behavior. Few studies have explored the underlying mechanism of the relationship between the perceived attitude of gender-specific close friends and hookup behavior. Following the social norm approach and the social learning theory, a person’s own hookup attitude and their emotional reaction after a hookup would influence this relationship as mediators. We therefore examined the association between perceived hookup attitudes of students’ same-sex/opposite-sex close friends and the number of hookup partners via mediated variables (i.e., own hookup attitude and affect following a recent hookup) in Chinese college students (N = 314) who completed self-report measures at 6-month intervals. The results of a path analysis showed that students’ own attitudes toward hookups and negative affect following a hookup significantly mediated the association between perceived hookup attitudes of same-sex close friends and the number of hookup partners over 6 months. These findings indicate that same-sex close friends’ injunctive norms were more strongly associated with future hookup behavior, as compared to opposite-sex friends’ injunctive norms. To better understand the relationship between peer norms and hookup behavior, both students’ hookup attitudes and negative emotional responses should be considered.

Mental Health Risk Among Members of the Millennial Population Cohort: A Concern for Public Health

PURPOSE

Within the millennial population cohort, identify groups reporting increased risk of nonspecific psychological distress. As the largest living population cohort, taking stock of health and well-being early is necessary as substantial national resources may be needed as this cohort ages.

DESIGN

The 2017 National Health Interview Survey data, an annual multipurpose survey of the US population, was used.

SAMPLE

A sample of 7303 respondents were created by limiting data set to birth years 1980 to 1998.

MEASURES

Outcomes were feeling like everything is an effort, worthlessness, hopelessness, restlessness, nervousness, and sadness. Combined these statements of feeling make up a measure of nonspecific psychological distress, past 30 days.

ANALYSIS

A logistic regression was performed on each outcome. All models controlled for demographic variables known to be associated with psychological distress.

RESULTS

Females are 1.4 times more likely than males to report nonspecific psychological distress (P < .001), whereas Hispanics and Blacks are less likely to report nonspecific psychological distress (odds ratio [OR] = 0.49, OR = 0.57, P < .001). American Indians were less likely to report worthlessness (OR = 0.30, P < .05). However, multiple race individuals increasingly reported hopelessness (OR = 1.55, P < .05). Young adults are less likely than emerging adults to report sadness (OR = 0.85, P < .05).

CONCLUSION

In this sample, racial/ethnic groups fared better than referent groups. Health programs need to integrate intersectional identities into promotion of mental health.

The Many Facets of Erythropoietin Physiologic and Metabolic Response

In mammals, erythropoietin (EPO), produced in the kidney, is essential for bone marrow erythropoiesis, and hypoxia induction of EPO production provides for the important erythropoietic response to ischemic stress, such as during blood loss and at high altitude. Erythropoietin acts by binding to its cell surface receptor which is expressed at the highest level on erythroid progenitor cells to promote cell survival, proliferation, and differentiation in production of mature red blood cells. In addition to bone marrow erythropoiesis, EPO causes multi-tissue responses associated with erythropoietin receptor (EPOR) expression in non-erythroid cells such neural cells, endothelial cells, and skeletal muscle myoblasts. Animal and cell models of ischemic stress have been useful in elucidating the potential benefit of EPO affecting maintenance and repair of several non-hematopoietic organs including brain, heart and skeletal muscle. Metabolic and glucose homeostasis are affected by endogenous EPO and erythropoietin administration affect, in part via EPOR expression in white adipose tissue. In diet-induced obese mice, EPO is protective for white adipose tissue inflammation and gives rise to a gender specific response in weight control associated with white fat mass accumulation. Erythropoietin regulation of fat mass is masked in female mice due to estrogen production. EPOR is also expressed in bone marrow stromal cells (BMSC) and EPO administration in mice results in reduced bone independent of the increase in hematocrit. Concomitant reduction in bone marrow adipocytes and bone morphogenic protein suggests that high EPO inhibits adipogenesis and osteogenesis. These multi-tissue responses underscore the pleiotropic potential of the EPO response and may contribute to various physiological manifestations accompanying anemia or ischemic response and pharmacological uses of EPO.

Potential regulatory SNPs in the ATXN7L3B and KRT15 genes are associated with gender-specific colorectal cancer risk

Aim: According to the current data, a major factor for phenotypic variation of complex traits and disease susceptibility is the cis-acting effects of noncoding variants on gene expression. Our purpose was to evaluate the association between colorectal cancer (CRC) and six single nucleotide polymorphisms identified using our original bioinformatics approach as regulatory and putatively related to CRC. Materials: One hundred and sixty CRC patients and 185 healthy controls have been genotyped for rs590352, rs2072580, rs78317230, rs3829202, rs11542583 and rs4796672. Results: Genotypes and alleles distributions of rs590352 of ATXN7L3B gene were significantly different between the male CRC subjects and controls. Significant correlation of genotype with CRC is observable for women only for the rs4796672 of KRT15 gene. Analysis of haplotypes reveals that rs2072580 of the ISCU and SART3 genes can be also associated with CRC. Conclusion: We have identified three SNPs associated with CRC risk and demonstrated a gender specificity of rs590352 and rs4796672.

Gender-specific association between neutrophil-to-lymphocyte ratio and arterial stiffness in an apparently healthy population undergoing a health examination

Objective

Neutrophil-to-lymphocyte ratio (NLR) value has emerged as a cardiovascular prognostic marker. Although several recent studies suggested NLR was associated with arterial stiffness, it was still controversial. The aim of this study was to investigate the correlation between NLR and arterial stiffness by measuring of brachial-ankle pulse wave velocity (baPWV) in an apparently healthy population.

Methods

This retrospective study enrolled 5612 participants during the health examinations from 1 October 2007 to 30 September 2011. Arterial stiffness was measured by baPWV. NLR was calculated as the ratio of the absolute neutrophil count to the absolute lymphocyte count in peripheral blood. According to the quartiles of NLR, the patients were categorized into four groups in males and females, respectively. Associations between NLR and baPWV were evaluated using partial correlation and multivariate logistic regression analysis.

Results

Both female and male subjects with increased arterial stiffness (baPWV ≥ 1400 cm/s) were likely to be older (females: P < 0.001, males: P < 0.001) and have higher systolic blood pressure (females: P < 0.001, males: P < 0.001), diastolic blood pressure (females: P < 0.001, males: P < 0.001), fasting plasma glucose (females: P < 0.001, males: P < 0.001), serum total cholesterol (females: P < 0.001, males: P = 0.028), triglyceride (females: P < 0.001, males: P = 0.031), urea nitrogen (females: P < 0.001, males: P < 0.001) than those without increased arterial stiffness. In addition, compared to those without increased arterial stiffness, body mass index ( P < 0.001), waist circumference ( P < 0.001), low-density lipoproteins cholesterol ( P < 0.001), creatinine ( P < 0.001), uric acid ( P < 0.001) and lymphocytes ( P = 0.001) were higher in females with increased arterial stiffness. However, males with increased arterial stiffness had higher NLR value (2.0 ± 0.7 vs. 2.1 ± 0.9, P < 0.001) and neutrophils (4.3 ± 1.4 vs. 4.5 ± 1.5, P < 0.001) than those without increased arterial stiffness, while the difference was not found in females. ANCOVA showed that males with quartile 3 and quartile 4 of NLR had greater levels of baPWV. NLR was correlated to baPWV in males by partial correlation analysis (r = 0.110, P < 0.001), but not in females. In multiple logistic regression analysis, the quartile 4 of NLR was positively associated with increased arterial stiffness in males (OR = 1.43, 95% confidence intervals [CI]=1.12–1.82, P = 0.004), but there was no obvious correlation in females.

Conclusions

Our findings suggest that there is a gender difference in the relationship between arterial stiffness and NLR. After adjusting for other confounders, the risk of increased arterial stiffness in apparently healthy adult males (rather than females) is independently associated with the highest quartile of NLR.

Functional and structural networks of lateral and medial orbitofrontal cortex as potential neural pathways for depression in childhood

BACKGROUND

Converging evidence suggests that the lateral and medial orbitofrontal cortices (lOFC and mOFC) may contribute distinct neural mechanisms in depression. This study investigated the relations of their functional and structural organizations with postnatal maternal depressive symptoms in young children.

METHODS

Resting-state functional magnetic resonance imaging and structural magnetic resonance imaging were acquired in children at age 4 (n = 199) and 6 years (n = 234). Child's withdrawal behavior problems were assessed using Child's Behavior Checklist.

RESULTS

In 4-year-old girls, postnatal maternal depressive symptoms were positively associated with the lOFC functional connectivity with the visual network but negatively with the cognitive control network. The lOFC functional connectivity with the visual network and cerebellum, which was influenced by postnatal maternal depressive symptoms, was also associated with child's withdrawal behavior problems in 6-year-old girls. Moreover, postnatal maternal depressive symptoms were also negatively associated with the mOFC functional connectivity with the cognitive control and motor networks in 4-year-old girls. Furthermore, postnatal maternal depressive symptoms influenced the structural connectivity of left mOFC with the right middle frontal cortex and left inferior temporal cortex in 4-year-old girls. Unlike girls, boys showed that postnatal maternal depressive symptoms selectively impacted the mOFC functional connectivity with the memory system at age 6 years.

CONCLUSION

Our study provided novel evidence on the distinct neural mechanisms of the lOFC and mOFC structural and functional organizations for intergenerational transmission of maternal depression to the offspring. Boys and girls may potentially employ different neural mechanisms to adapt to maternal environment at different timings of early life.

Prevalence and Gender-Specific Influencing Factors of Hypertension among Chinese Adults: A Cross-Sectional Survey Study in Nanchang, China

Hypertension has become the leading cause of death worldwide; data on hypertension among Nanchang adults are sparse. The aim of this study was to investigate the prevalence and gender-specific influencing factors of hypertension in adults in Nanchang, China. A cross-sectional survey was conducted with a representative sample of 2722 Chinese residents aged 18 years and above between May and September 2016, with a response rate of 92.4% (2516/2722). A stratified cluster sampling method was adopted in this study. Data on prevalence and influencing factors were obtained from a standard questionnaire and physical measurements. Univariate and multivariate logistic regressions were performed to analyze the influencing factors. The age-standardized prevalence was 19.8% (18.2-21.3) (male: 19.5% (18.0-21.1); female, 20.01% (18.5-21.6)). Factors positively associated with hypertension prevalence were past smoking, diabetes mellitus (DM), and overweight and obesity in both genders. Abdominal obesity and family history of cardiovascular diseases (CVD) were risk factors only in males; sleeping time and consumption of fresh vegetables and fruits were related to the prevalence of hypertension only in females. These findings will form the baseline information for the development of more effective approaches to enhance current prevention and control management of hypertension.

Profiles and Gender-Specifics of UDP-Glucuronosyltransferases and Sulfotransferases Expressions in the Major Metabolic Organs of Wild-Type and Efflux Transporter Knockout FVB Mice

Hepatic and extrahepatic tissues participate in xenobiotic detoxication, carcinogen activation, prodrug processing, and estrogen regulation through UDP-glucuronosyltransferases (UGTs/Ugts) and sulfotransferases (SULTs/Sults). Wild-type (WT) and efflux transporter knockout (KO) FVB mice have been commonly used to perform the studies of pharmacokinetics, metabolism, and toxicity. We employed the developed UHPLC-MS/MS approach to gain systematic insight on gender-specific of Ugts and Sults in major metabolic organs. Results showed that the liver was the most abundant with Ugts/Sults, followed by the small intestine and the kidney. In the liver, Ugt2b5, Ugt2b1, Ugt1a6a, Ugt1a1, Sult1a1, and Sult1d1 were the major isoforms. The protein amounts of Ugt1a9 were significantly higher in male efflux transporter KO mice than in WT mice, whereas Ugt1a5 and Sult1a1 severely decreased in female efflux transporter KO mice. In WT and efflux transporter KO mice, the expression levels of Ugt1a1, Ugt1a5, Sult1a1, Sult1d1, and Sult3a1 were female-specific, whereas those of Ugt2b1, Ugt2b5, and Ugt2b36 were male-specific. In the small intestine, Ugt1a1, Sult1b1, and Sult2b1 were the major isoforms. The protein levels and gender differences of Ugts/Sults were obviously affected when KO of Mdr1a, and Bcrp1, Mrp1, Mrp2, and Mdr1a, respectively. The KO of efflux transporter affected the protein amounts of Ugts/Sults in the kidney, heart, and spleen. Therefore, a better understanding of the expression profiles and gender-specific of Ugts and Sults in major metabolic organs of WT and efflux transporter KO mice is useful for the evaluation of potential efficacy, and toxicity of corresponding substrates.

Gender- and Age-Specific REE and REE/FFM Distributions in Healthy Chinese Adults

Basic data on the resting energy expenditure (REE) of healthy populations are currently rare, especially for developing countries. The aims of the present study were to describe gender- and age-specific REE distributions and to evaluate the relationships among glycolipid metabolism, eating behaviors, and REE in healthy Chinese adults. This cross-sectional survey included 540 subjects (343 women and 197 men, 20–79 years old). REE was measured by indirect calorimetry and expressed as kcal/day/kg total body weight. The data were presented as the means and percentiles for REE and the REE to fat-free mass (FFM) ratio; differences were described by gender and age. Partial correlation analysis was used to analyze the correlations between REE, tertiles of REE/FFM, and glycolipid metabolism and eating behaviors. In this study, we confirmed a decline in REE with age in women (p = 0.000) and men (p = 0.000), and we found that men have a higher REE (p = 0.000) and lower REE/FFM (p = 0.021) than women. Furthermore, we observed no associations among glycolipid metabolism, eating behaviors, and REE in healthy Chinese adults. In conclusion, the results presented here may be useful to clinicians and nutritionists for comparing healthy and ill subjects and identifying changes in REE that are related to aging, malnutrition, and chronic diseases.

Developing a Web-Based Intervention to Prevent Drug Use among Adolescent Girls

OBJECTIVES

Girls' rates of drug use have met up with, and in some instances, surpassed boys' use. Though girls and boys share risk and protective factors associated with drug use, girls also have gender-specific risks. Interventions to prevent girls' drug use must be tailored to address the dynamics of female adolescence.

METHODS

One such intervention, called RealTeen, is a 9-session, web-based drug abuse prevention program designed to address such gender-specific risk factors associated with young girls' drug use as depressed mood, low self-esteem, and high levels of perceived stress as well as general drug use risk factors of peer and social influences. Web-based delivery enables girls to interact with the program at their own pace and in a location of their choosing.

IMPLICATIONS

This paper describes the processes and challenges associated with developing and programming a gender-specific, web-based intervention to prevent drug use among adolescent girls.

An evaluation study of a gender-specific smoking cessation program to help Hong Kong Chinese women quit smoking

BACKGROUND

There is a lack of population-based smoking cessation interventions targeting woman smokers in Hong Kong, and in Asia generally. This study aimed to evaluate the effectiveness of a gender-specific smoking cessation program for female smokers in Hong Kong.

METHODS

To evaluate the effectiveness of the service, a total of 457 eligible smokers were recruited. After the baseline questionnaire had been completed, a cessation counseling intervention was given by a trained counselor according to the stage of readiness to quit. Self-reported seven-day point prevalence of abstinence and reduction of cigarette consumption (≥50 %) and self-efficacy in rejecting tobacco were documented at one week and at two, three and six months.

RESULTS

The 7-day point prevalence quit rate was 28.4 % (130/457), and 21.9 % (100/457) had reduced their cigarette consumption by at least 50 % at the six-month follow-up. The average daily cigarette consumption was reduced from 8.3 at baseline to 6.3 at six months. Moreover, both internal and external stimuli of anti-smoking self-efficacy increased from baseline to six months.

CONCLUSIONS

The study provides some evidence for the effectiveness of the gender-specific smoking cessation program for female smokers. Furthermore, helping smokers to improve their self-efficacy in resisting both internal and external stimuli of tobacco use can be a way of enhancing the effectiveness of a smoking cessation intervention.

No Gender-Based Differences in Outcomes after Conventional Total Knee Arthroplasty in Asians

PURPOSE

The purpose of this study is to evaluate the effect of gender on functional outcomes in Asian patients undergoing conventional total knee arthroplasty (TKA).

PATIENTS AND METHODS

A review of 217 patients who underwent primary total knee arthroplasty by a single surgeon was conducted. Postoperative range of motion, Knee Society Score, Oxford Knee Score and Short Form-36 Physical Component Score (PCS) and Mental Component Score (MCS) were collected prospectively in all patients at both 6 months and 2 years following conventional TKA. The patients were then stratified based on gender and their outcomes were compared using Student's t-test.

RESULTS

Preoperatively, the females had a significantly poorer flexion range as compared to the males. Postoperatively at 6 months and 2 years following conventional TKA, both groups showed improvement from their preoperative range of motion and scores and had no significant differences in outcomes.

CONCLUSION

Similar to several studies in the Western literature, gender does not seem to affect short-term outcomes in Asian patients undergoing TKA. Longer-term data on survivorship and outcomes are needed before routine use of gender-specific TKA can be recommended.

Effects of fetal microwave radiation exposure on offspring behavior in mice

The recent rapid development of electronic communication techniques is resulting in a marked increase in exposure of humans to electromagnetic fields (EMFs). This has raised public concerns about the health hazards of long-term environmental EMF exposure for fetuses and children. Some studies have suggested EMF exposure in children could induce nervous system disorders. However, gender-dependent effects of microwave radiation exposure on cognitive dysfunction have not previously been reported. Here we investigated whether in utero exposure to 9.417-GHz microwave throughout gestation (Days 3.5-18) affected behavior, using the open field test (OFT), elevated-plus maze (EPM), tail suspension test (TST), forced swimming test (FST) and Morris water maze (MWM). We found that mice showed less movement in the center of an open field (using the OFT) and in an open arm (using the EPM) after in utero exposure to 9.417-GHz radiation, which suggested that the mice had increased anxiety-related behavior. Mice demonstrated reduced immobility in TST and FST after in utero exposure to 9.417-GHz radiation, which suggested that the mice had decreased depression-related behavior. From the MWM test, we observed that male offspring demonstrated decreased learning and memory, while females were not affected in learning and memory, which suggested that microwaves had gender-dependent effects. In summary, we have provided the first experimental evidence of microwaves inducing gender-dependent effects.

Suicidal Ideation of Probationers. Gender Differences

BACKGROUND

Gender is often related to different life stressors and mental health disorders, but a limited amount of research examines risks of suicidal ideation of probationers by gender.

AIMS

The aim of this study was to examine gender differences in suicidal ideation of probationers.

METHOD

Using a national sample of 3,014 male and 1,306 female probationers with data from the National Survey on Drug Use and Health (2009-2011), multivariate regression analysis was conducted.

RESULTS

Male and female probationers display similar demographic characteristics although their life circumstances and experiences seem different. Female probationers in the study were more likely to experience financial, psychological, and residential stressors than male probationers were. Female probationers were also more likely to have received medical and/or psychiatric treatments. Female probationers were exposed to more suicidal ideation risks than male probationers were. Additionally, no protective factors to suicidal ideation were found for female probationers.

CONCLUSION

The findings suggest that a gender-specific approach to suicidal ideation of probationers may lessen the prevalence of suicidal ideation of this largely neglected population.

A review of treatment options for co-occurring methamphetamine use disorders and depression

Co-occurring methamphetamine use and depression interferes with treatment outcomes. Female methamphetamine users are known to have higher rates of depression than male methamphetamine users, although this is also true for the general population. There are limited treatment options for the management of depression among methamphetamine users. In this integrative review, we summarize data on treatment strategies for co-occurring depression and methamphetamine use disorders. English-language articles were identified from PsychINFO, CINAHL, PubMed, and Medline as well as from reference lists of key articles. Search terms included "methamphetamine," "depression," and "treatment." Research articles describing psychological (n = 3), pharmacological (n = 6), nutritional supplement (n = 1), and psychological combined with pharmacological (n = 3) approaches for the treatment of methamphetamine use or withdrawal and/or depression are included in this review. Psychological and combination of psychological with pharmacological approaches have not been shown to be effective in treating these co-occurring conditions. Antidepressants have been determined to be ineffective and/or to introduce side effects. Gender differences with response to treatment were examined in only one of the published studies. There is a large gap in knowledge regarding treatment of co-occurring methamphetamine use disorders and depression. Considering that female methamphetamine users experience higher rates of depression than men, a focus on gender-specific treatment approaches is warranted.

Gender-specific association of variants in the AKR1C1 gene with dimensional anxiety in patients with panic disorder: additional evidence for the importance of neurosteroids in anxiety?

BACKGROUND

Neurosteroids are synthesized both in brain and peripheral steroidogenic tissue from cholesterol or steroidal precursors. Neurosteroids have been shown to be implicated in neural proliferation, differentiation, and activity. Preclinical and clinical studies also suggest a modulatory role of neurosteroids in anxiety-related phenotypes. However, little is known about the contribution of genetic variants in genes relevant for the neurosteroidogenesis to anxiety disorders.

METHODS

We performed an association analysis of single nucleotide polymorphisms (SNPs) in five genes related to the neurosteroidal pathway with emphasis on progesterone and allopregnanolone biosynthesis (steroid-5-alpha-reductase 1A (SRD5A1), aldo-keto reductase family 1 C1-C3 (AKR1C1-AKR1C3) and translocator protein 18 kDA (TSPO) with panic disorder (PD) and dimensional anxiety in two German PD samples (cases N = 522, controls N = 1,115).

RESULTS

Case-control analysis for PD and SNPs in the five selected genes was negative in the combined sample. However, we detected a significant association of anticipatory anxiety with two intronic SNPs (rs3930965, rs41314625) located in the gene AKR1C1 surviving correction for multiple testing in PD patients. Stratification analysis for gender revealed a female-specific effect of the associations of both SNPs.

CONCLUSIONS

These results suggest a modulatory effect of AKR1C1 activity on anxiety levels, most likely through changes in progesterone and allopregnanolone levels within and outside the brain. In summary, this is the first evidence for the gender-specific implication of the AKR1C1 gene in the expression of anticipatory anxiety in PD. Further analyses to unravel the functional role of the SNPs detected here and replication analyses are needed to validate our results.

Gender-specific effects of a phytogenic feed additive on performance, intestinal physiology and morphology in broiler chickens

To date, most studies published were carried out on broilers of the same sex, and possible gender-specific effects of phytogenic substances have not been investigated so far. A 3 × 2 factorial study was performed to examine gender-specific effects of a PFA at two dietary levels (150, 1500 ppm) on growth performance, carcass traits and gastrointestinal attributes in broiler chickens versus an untreated control group. The addition of 150 ppm of the PFA led to a downregulation of trypsinogen mRNA in pancreas compared with the control group (p < 0.05). The number of goblet cells decreased in jejunum compared with the unsupplemented group, whereby this effect was more pronounced in male birds (p < 0.05). Furthermore, higher methylamine contents compared with the control group were measured (p < 0.01). In proximal ileum, female birds, supplemented with 150 ppm PFA, had lower crypt depths than their litters in the 1500 ppm treatment (p < 0.05). In distal ileum, villus height:crypt depth ratio was higher in birds fed the PFA at 150 ppm than in the control group (p < 0.05). The 1500 ppm dosage of the PFA increased jejunal histamine concentration compared with the negative control group (p < 0.05). Jejunal histamine concentration was also affected by the interaction PFA × sex (p < 0.05). Regardless of inclusion level, total amount of biogenic amines and other microbial metabolites in digesta samples was not affected by the PFA. These results demonstrate variable, partially gender-specific effects of the tested PFA. Although the supplementation of 150 ppm showed little effect on mRNA expression level of selected marker genes for nutrient digestion, beneficial effects on gut morphology were observed. The 10-fold higher dosage of the PFA did not adversely affect growth performance as well as most investigated parameters compared with the control group.

Optimum lean body formulation for correction of standardized uptake value in PET imaging

Standardized uptake value (SUV) normalized by lean body mass ([LBM] SUL) is becoming a popular metric for quantitative assessment of clinical PET. Sex-specific quantitative effects of different LBM formulations on liver SUV have not been well studied.

METHODS

(18)F-FDG PET/CT scans from 1,033 consecutive adult (501 women, 532 men) studies were reviewed. Liver SUV was measured with a 3-cm-diameter spheric region of interest in the right hepatic lobe and corrected for LBM using the sex-specific James and Janmahasatian formulations.

RESULTS

Body weight was 71.0 ± 20.7 kg (range, 18.0-175.0 kg) and 82.9 ± 18.6 kg (range, 23.0-159.0 kg) for women and men, respectively. SUV, based on body weight, has a significantly positive correlation with weight for both women (r = 0.58, P < 0.0001) and men (r = 0.54, P < 0.0001). This correlation is reduced in men (r = 0.11, P = 0.01) and becomes negative for women (r = -0.35, P = 0.0001) with the James formulation of SUL. This negative correlation was eliminated when the very obese women (body mass index ≥ 35) were excluded from the analysis (r = 0.13, P = 0.8). The Janmahasatian formulation annuls the correlation between SUL and weight for women (r = 0.04, P = 0.4) and decreases it for men (r = 0.13, P = 0.003).

CONCLUSION

Hepatic correction with the more common James formulation for body lean mass breaks down and shows low SUL values in very obese patients. The adoption of the Janmahasatian formula for estimation of LBM in modern PET scanners and display workstations is recommended, in view of the increasing frequency of obesity.