Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk
It is known that healthy women during childbearing years have a lower risk of cardiovascular disease (CVD) and coronary heart disease compared to age matched men. Various traditional risk factors have been shown to confer differential CVD susceptibilities by sex. Atherosclerosis is a major cause of...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.914016/full |
| _version_ | 1828821043379175424 |
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| author | George A. Robinson George A. Robinson Ines Pineda-Torra Coziana Ciurtin Coziana Ciurtin Elizabeth C. Jury |
| author_facet | George A. Robinson George A. Robinson Ines Pineda-Torra Coziana Ciurtin Coziana Ciurtin Elizabeth C. Jury |
| author_sort | George A. Robinson |
| collection | DOAJ |
| description | It is known that healthy women during childbearing years have a lower risk of cardiovascular disease (CVD) and coronary heart disease compared to age matched men. Various traditional risk factors have been shown to confer differential CVD susceptibilities by sex. Atherosclerosis is a major cause of CVD and mortality and sex differences in CVD risk could be due to reduced atherogenic low and very low-density lipoproteins (LDL and VLDL) and increased atheroprotective high density lipoproteins (HDLs) in women. In contrast, patients with systemic lupus erythematosus (SLE), a chronic inflammatory disease that predominately affects women, have an increased atherosclerotic and CVD risk. This increased CVD risk is largely associated with dyslipidaemia, the imbalance of atherogenic and atheroprotective lipoproteins, a conventional CVD risk factor. In many women with SLE, dyslipidaemia is characterised by elevated LDL and reduced HDL, eradicating the sex-specific CVD protection observed in healthy women compared to men. This review will explore this paradox, reporting what is known regarding sex differences in lipid metabolism and CVD risk in the healthy population and transgender individuals undergoing cross-sex hormone therapy, and provide evidence for how these differences may be compromised in an autoimmune inflammatory disease setting. This could lead to better understanding of mechanistic changes in lipid metabolism driving the increased CVD risk by sex and in autoimmunity and highlight potential therapeutic targets to help reduce this risk. |
| first_indexed | 2024-12-12T12:47:06Z |
| format | Article |
| id | doaj.art-868a11451a4c426db94ac71e8db56a7e |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-12T12:47:06Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-868a11451a4c426db94ac71e8db56a7e2022-12-22T00:24:05ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-05-01910.3389/fmed.2022.914016914016Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease RiskGeorge A. Robinson0George A. Robinson1Ines Pineda-Torra2Coziana Ciurtin3Coziana Ciurtin4Elizabeth C. Jury5Division of Medicine, Centre for Rheumatology Research, University College London, London, United KingdomDivision of Medicine, Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United KingdomDivision of Medicine, Centre for Cardiometabolic and Vascular Science, University College London, London, United KingdomDivision of Medicine, Centre for Rheumatology Research, University College London, London, United KingdomDivision of Medicine, Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United KingdomDivision of Medicine, Centre for Rheumatology Research, University College London, London, United KingdomIt is known that healthy women during childbearing years have a lower risk of cardiovascular disease (CVD) and coronary heart disease compared to age matched men. Various traditional risk factors have been shown to confer differential CVD susceptibilities by sex. Atherosclerosis is a major cause of CVD and mortality and sex differences in CVD risk could be due to reduced atherogenic low and very low-density lipoproteins (LDL and VLDL) and increased atheroprotective high density lipoproteins (HDLs) in women. In contrast, patients with systemic lupus erythematosus (SLE), a chronic inflammatory disease that predominately affects women, have an increased atherosclerotic and CVD risk. This increased CVD risk is largely associated with dyslipidaemia, the imbalance of atherogenic and atheroprotective lipoproteins, a conventional CVD risk factor. In many women with SLE, dyslipidaemia is characterised by elevated LDL and reduced HDL, eradicating the sex-specific CVD protection observed in healthy women compared to men. This review will explore this paradox, reporting what is known regarding sex differences in lipid metabolism and CVD risk in the healthy population and transgender individuals undergoing cross-sex hormone therapy, and provide evidence for how these differences may be compromised in an autoimmune inflammatory disease setting. This could lead to better understanding of mechanistic changes in lipid metabolism driving the increased CVD risk by sex and in autoimmunity and highlight potential therapeutic targets to help reduce this risk.https://www.frontiersin.org/articles/10.3389/fmed.2022.914016/fullsex and genderlipoproteinsautoimmunityatherosclerosisSLE |
| spellingShingle | George A. Robinson George A. Robinson Ines Pineda-Torra Coziana Ciurtin Coziana Ciurtin Elizabeth C. Jury Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk Frontiers in Medicine sex and gender lipoproteins autoimmunity atherosclerosis SLE |
| title | Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk |
| title_full | Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk |
| title_fullStr | Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk |
| title_full_unstemmed | Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk |
| title_short | Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk |
| title_sort | sex differences in lipid metabolism implications for systemic lupus erythematosus and cardiovascular disease risk |
| topic | sex and gender lipoproteins autoimmunity atherosclerosis SLE |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.914016/full |
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