The incidence of chronic kidney disease is increasing worldwide, which greatly increases the risk of end-stage renal disease. It is particularly important to find out the risk factors for the development and progression of chronic kidney disease. Whether gender is a risk factor for the progression of kidney disease remains controversial with inconsistent results in human cohort studies with diabetic or non-diabetic kidney disease. In most of the studies, women seem to exhibit certain gender advantages. Sex hormones, renal hemodynamics and lifestyle differences may play an important role. The underlying mechanism of gender affecting the progression of kidney disease deserves further exploration. This article reviews the gender differences and possible mechanisms in diabetic and non-diabetic chronic kidney disease, in order to provide reference for future research.
Objective To explore the impact of gender difference in 90-day outcomes after mechanical thrombectomy for acute cerebral infarction. Methods A prospective registration, observational, and retrospective analysis study was carried out. Patients with acute cerebral infarction who were admitted to the Department of Neurology of the First Affiliated Hospital of Chengdu Medical College and the Department of Neurology of Nanjing First Hospital between June 2015 and June 2019 were collected. Patients were divided into two groups based on gender. The detailed demographic, laboratory examination, imaging examination and clinical data were collected. Then, the data were analyzed using univariate and multivariate logistic regression analyses. Results A total of 298 patients were included. Among them, there were 185 males and 113 females. The differences in age, smoking, atrial fibrillation, using antiplatelet drugs before stroke, TOAST classification, and involved cerebrovascular sites between the two groups were statistically significant (P<0.05), and there was no statistically significant difference in other baseline data between the two groups (P>0.05). The results of univariate logistic regression analysis showed that the rate of 90-day favourable outcome of female patients was lower than that of male patients [odds ratio (OR)=0.462, 95% confidence interval (CI) (0.275, 0.775), P=0.030]. The results of multivariate logistic regression analysis showed that, after adjusting for confounding factors, there was no independent correlation between gender and the 90-day favourable outcome of patients with acute cerebral infarction who underwent mechanical thrombectomy [OR=1.511, 95% CI (0.745, 3.066), P=0.253]. Conclusion The gender has no significant effect on the 90-day favourable outcome of acute cerebral infarction patients treated with mechanical thrombectomy.
ObjectiveTo summarize the research progress of the design and effectiveness of gender-specific prosthesis in total knee arthroplasty (TKA). MethodsThe relevant literature on gender-specific prosthesis in recent years was extensively reviewed and analyzed. ResultsGender-specific prosthesis is designed according to the female knee joint anatomical characteristics. In theory, it should obtain better effectiveness. But a large number of clinical studies have shown that the knee function, pain, and satisfaction has no obvious advantage when compared with conventional prosthesis after TKA for female patient. ConclusionComprehensive evaluation should be considered when gender-specific is selected; and the effectiveness needs further follow-up.
Knee osteoarthritis (KOA) is one of the common degenerative joint diseases, which is more common in the middle-aged and elderly population. It shows significant gender differences, with a significantly higher incidence rate in women than in men, seriously affecting the quality of life of patients. However, there are few research reports on the correlation between gender differences and the incidence of KOA both domestically and internationally. Therefore, this article will summarize and analyze the potential causes of gender differences related to the incidence of KOA from five aspects: hormone levels, anatomical biomechanical characteristics, genes, obesity, and exercise-muscle factors. Through a comprehensive review of research progress, the aim is to provide a theoretical basis for gender based personalized treatment of KOA in clinical practice.
【摘要】 目的 探讨男性和女性糖尿病肾病患者危险因素之间的差异。方法 收集2004年1月—2008年12月以糖尿病肾病为诊断的住院患者1 300例,根据入院日期以系统的方法随机纳入650例患者,排除20例尿常规正常和血肌酐值正常的患者,共630例,其中男342例,女288例,平均年龄65岁。288例女性患者中有271例为绝经后妇女,平均年龄48岁。比较女性和男性糖尿病肾病患者危险因素的差别。结果 ①绝经后糖尿病肾病患者占女性患者的94.1%；②女性糖尿病肾病患者组收缩压、脉压及糖化血红蛋白水平高于男性糖尿病肾病患者组,两者有统计学意义(Plt;0.05)；③两组患者在发病年龄,病程,糖尿病家族史,空腹血糖水平,低密度脂蛋白,高密度脂蛋白,血肌酐,24 h尿蛋白定量、是否使用血管紧张素转换酶抑制剂,血管紧张素受体拮抗剂,胰岛素,是否透析,死亡率均无统计学意义(Pgt;0.05)。结论 在女性糖尿病肾病患者中绝经后妇女所占比例较高,女性糖尿病肾病患者收缩压、脉压及糖化血红蛋白水平均高于男性糖尿病肾病患者,雌激素的水平可能导致差异的产生。
ObjectiveTo analyze the glycated hemoglobin A1c (HbA1c) level among healthy adults in Quanzhou area and explore distribution of HbA1c concentration by age and gender, and establish relevant reference range. MethodsUnder the standardized test of HbA1c, HbA1c concentrations of 1 931 healthy adults were determined by HLC-723 G8 HbA1c analyzer (TOSOH corp, Japan) and its agents. HbA1c levels of different age (18-30, 31-40, 41-50, 51-60, >60) and gender groups were compared, percentile was adopted to establish the corresponding HbA1c reference range of healthy adults in Quanzhou area according to "WS/T402-12-2012. Define and Determine the Reference Interval in Clinical Laboratory" and CLSI C28-A3. ResultsThe total HbA1c levels among healthy adults in Quanzhou area were 3.8%-6.4% (5.31%±0.40%), and the total HbA1c levels among male and female healthy adults in Quanzhou area were 5.55%±0.36% and 5.47%±0.43%, respectively, HbA1c concentration between different gender were statistically significant (P≤0.01). Compared in HbA1c levels of different age (18-30, 31-40, 41-50, 51-60, >60) and gender groups: the difference of HbA1c concentration between different gender in 18-30 years and 31-40 years group was statistically significant (P<0.05) and on the contrary the remaining three age groups were no statistically significant. Compared in HbA1c levels of different age groups in male: the difference of HbA1c concentration between different age groups in 31-40 years and 41-50 years group were no statistically significant (P>0.05), but statistically significant (P<0.05) in the remaining three age groups. The difference of HbA1c concentration between different age groups in female were statistically significant (all P values ≤0.01). The reference intervals of HbA1c for males and females were 4.8%-6.2% and 4.6%-6.3%, respectively, with statistically significant (P=0.000); the reference intervals of HbA1c according to age and gender were: for 18-30 years in males and females were 4.6%-6.0% and 4.4%-6.0%, respectively, with statistically significant (P≤0.01); for 31-40 years in males and females were 4.7%-6.0% and 4.7%-6.2%, respectively, with statistically significant (P≤0.01); for 41-50 years, 51-60 years, >60 years in males and females were no statistically significant (P>0.05), the reference intervals were 4.8%-6.2%, 4.8%-6.4%, and 5.1%-6.4%, respectively. Compared in HbA1c reference intervals in this paper with ADA and Chinese Clinical Operating Program, the difference were statistically significant (P=0.000). ConclusionUnder the standardized test of HbA1c, HbA1c concentrations of age and gender groups of 1 931 healthy adults in Quanzhou area are partial different, the reference interval of HbA1c of age and gender groups for healthy adults in Quanzhou area are established.
Objective To investigate the difference in first onset age, family history and medication compliance between male and female patients with schizophrenia in communities. Methods We used self-designed questionnaire to survey and analyze 372 cases of schizophrenia between June to August 2014. Results There were no significant differences between male and female schizophrenic patients in the family history, personality before the disease, education level, age, and the onset type and disease course (P > 0.05). The first onset age of male patients [(24.92±8.22) years] was significantly earlier than female patients [(27.02±11.28) years] and the difference was statistically significant (P < 0.05). The number of unmarried male patients (115, 58.97%) was significantly more than unmarried females (81, 45.76%) and the difference was statistically significant (P < 0.05). The full medication compliance rate of female patients (127, 71.75%) was significantly better than that of male patients (115, 58.97%) (P < 0.05). Conclusion The first onset age, marital status and medication compliance are significantly different between the two genders of patients with schizophrenia, which indicates that prevention, treatment and recovery measures for male and female patients should be differentiated.
目的 探讨不同性别IgA肾病患者合并高尿酸血症的临床及肾脏病理特点。 方法 采用回顾性研究方法，将2008年1月－2010年12月收治的226例经肾活检确诊的原发性IgA肾病患者分为男性高尿酸血症组、男性尿酸正常组、女性高尿酸血症组及女性尿酸正常组4组，统计分析4组的临床指标及病理指标。 结果 高尿酸血症患病率男性（21.7%）高于女性（11.9%），差异有统计学意义（P＜0.01），尿检异常型患病率男性（14.6%）高于女性（4.0%），差异有统计学意义（P＜0.01），女性LeeⅢ级的患病率（7.1%）高于男性（5.8%），差异有统计学意义（P＜0.01）；男性高尿酸血症组的尿素氮高于尿酸正常组（P＜0.05），女性高尿酸血症组的血尿素氮、血肌酐、胱抑素C、舒张压、甘油三酯比尿酸正常者明显增高（P＜0.01），女性高尿酸血症组的高密度脂蛋白明显高于男性组（P ＜0.01）。 结论 高尿酸血症是IgA肾病的危险因素，可导致更严重的肾功能损害及肾脏病理损害，这种影响在不同性别中存在差异。
Objective To systematically review the sex differences in efficacy of immune checkpoint inhibitors (ICIs) for non-small cell lung cancer (NSCLC) patients. Methods We conducted a computer search of Medline, The Cochrane Library, and EMbase from inception to November 2022 to identify randomized controlled trials (RCTs) assessing the efficacy of ICIs in patients with NSCLC. A meta-analysis was performed using RevMan 5.4 software. ResultsFinally 16 RCTs with a total of 9 653 patients were included, and the modified Jadad scale score was≥4 points. Meta-analysis results showed that in female NSCLC patients receiving immune therapy, the median overall survival (OS) [HR=0.72, 95%CI (0.61, 0.85), P<0.001] was longer than that in males [HR=0.73, 95%CI (0.69, 0.78), P<0.001]. Males [HR=0.64, 95%CI (0.58, 0.71), P<0.001] had an advantage over females [HR=0.76, 95%CI (0.57, 1.03), P=0.760] in median progression-free survival (PFS). Conclusion Females receiving ICIs have an advantage over males in terms of median OS. However, males tend to derive greater benefit from ICIs in terms of median PFS.
ObjectiveTo systematically evaluate the efficacy of immune checkpoint inhibitors (ICIs) in treating esophageal cancer patients of different genders. MethodsComputer searches were conducted on PubMed, The Cochrane Library, and EMbase databases to collect randomized controlled trial (RCT) on ICIs treatment for esophageal cancer patients from the establishment of the databases to January 25, 2024. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. The outcome indicators were overall survival (OS) and progression-free survival (PFS), and RevMan 5.4 software was used for meta-analysis. The modified Jadad scoring scale was used to evaluate the quality of the included literature. ResultsA total of 10 RCT involving 5364 esophageal cancer patients were included in this study, with 2684 patients in the experimental group and 2680 patients in the control group. The Jadad scores of the included literature were all ≥6 points, indicating high-quality RCT. Meta-analysis results showed that female esophageal cancer patients receiving ICIs treatment [HR=0.72, 95%CI (0.59, 0.87), P<0.001] had a more significant median OS prolongation than male patients [HR=0.73, 95%CI (0.68, 0.78), P<0.001]; while male patients [HR=0.57, 95%CI (0.52, 0.64), P<0.001] had a more significant PFS prolongation than female patients [HR=0.72, 95%CI (0.55, 0.94), P=0.01]. Female patients treated with ICIs alone [HR=0.66, 95%CI (0.50, 0.87), P=0.003] had a more significant median OS prolongation than male patients [HR=0.79, 95%CI (0.72, 0.87), P<0.001]; while male patients receiving ICIs combined with chemotherapy [HR=0.67, 95%CI (0.61, 0.74), P<0.001] had a more significant median OS prolongation than female patients [HR=0.77, 95%CI (0.59, 1.01), P=0.06]. ConclusionFemale patients receiving ICIs have a slight advantage in OS compared to male patients, while male patients have an advantage in PFS. Male patients receiving ICIs combined with chemotherapy have better survival benefits than female patients, while female patients using ICIs monotherapy have better survival benefits than male patients.