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[Gender difference in alcoholic liver injury].

Gender differences of alcoholic liver injury have been described previously, but mechanisms have only partially characterized. For example, it is known that females develop alcoholic liver injury more rapidly and to a greater extent than males. It now appears that estrogen participates in several aspects of this phenomenon. On the other hand, attention has been directed towards the effect of ethanol ingestion on Kupffer cell function, which is stimulated by gut-derived endotoxins via mechanisms dependent on increased gut permeability and the possible relationship between Kupffer cell and alcohol-induced liver injury.

Female↗

Gender differences in free radical homeostasis during aging: shorter-lived female C57BL6 mice have increased oxidative stress.

Gender is a profound determinant of aging and lifespan, but little is known about gender differences in free radical homeostasis. Free radicals are proposed as key elements in the multifactorial process of aging and it is predicted that the longer-lived gender should have lower levels of oxidative stress. While the majority of studies on aging have included a single gender, recent studies in rats compared genders and found that females, the longer-lived sex, had lower oxidative stress and mitochondrial dysfunction than males. We explored the association between oxidative stress and gender-specific aging in C57BL6 mice, in which females are the shorter-lived gender. Reactive oxygen species (ROS) were measured in young and old mice by confocal imaging of dihydroethidium (DHE) oxidation in the brain, and by electron paramagnetic resonance (EPR) spectrometry of isolated brain mitochondria. Both genders exhibited significant age-dependent increases in ROS. However, females had a greater increase with age than males in DHE oxidation but not mitochondrial EPR. Superoxide dismutase 1 (Sod1) and glutathione peroxidase 1 (GPx1) protein levels were lower in old females. To determine whether enhancing antioxidant defenses would eliminate gender differences in lifespan, mice were treated chronically with a superoxide dismutase mimetic. Treatment blocked the age-dependent increase in ROS, with a greater effect in females on DHE oxidation, but not mitochondrial EPR. Treatment also increased lifespan to a greater degree in females. Our results indicate that differences in ROS homeostasis contribute to gender divergence in survival, but also suggest that mitochondrial superoxide production may not be primarily responsible for gender differences in lifespan.

Aging↗

Gender differences in long-term drug treatment outcomes in Chicago PETS.

Few long-term follow-up studies of substance abusers have examined gender differences. In the current study, gender differences were examined at 36 months following residential or outpatient drug-free treatment among 951 participants in the Chicago Target Cities Project, the majority of whom were female (62%) and African American (93%). There were no differences in the proportion of men and women who reported any alcohol or drug use at the 36-month follow-up, with an overall reduction of 41% from intake. Greater proportions of men were incarcerated or employed, whereas greater proportions of women had returned to treatment, lived with their children, lived with a substance user, or had interpersonal problems. Women, as a group, had greater increases over time in self-help participation, free time spent with family, non-using family/friends, and employment. Although both men and women showed significant improvements following treatment, gender differences persisted in several areas of psychosocial functioning related to recovery.

Adult↗

Gender differences in life expectancy among kibbutz members.

A literature review of findings reveals that the life expectancy (LE) of females is longer than that of males and that a strong relationship exists between LE and gender differences in LE. The arguments of biological vs societal reasons for such gender differences are presented and the kibbutz society is offered as a setting to test the rivaling hypotheses. It is argued that the kibbutz society offers more similar roles for both genders than outside the kibbutz and therefore the gender differences in LE should be reduced in comparison to what is expected, given the very high LE of kibbutz members. Statistical data of the kibbutz population between the years 1975-1980 are analyzed and the results support the following conclusions: female members have higher LE but the difference is much less than expected on the basis of a regression analysis of data from 73 societies; the difference is smaller due to the relatively higher gain in LE by males; the gender differences are even smaller at age 50 compared to LE differences at birth. The Discussion section dwells upon interpretations of the findings and argues against alternative interpretations that assume selection processes for the kibbutz population. Suggestions for further studies are also made.

Adolescent↗

Gender differences in general surgical careers: results of a post-residency survey.

BACKGROUND: This study's purpose was to gain perspective regarding general surgery career choices while examining gender differences. METHODS: Graduates of a general surgery residency (n = 189) received surveys addressing fellowship training, practice type, case composition, work hours, academic involvement, income, residency, and career satisfaction. RESULTS: Several gender differences were identified. Most men (64%) listed general surgery as their primary work type, whereas women most commonly reported breast surgery (38%, P < .001). More women worked <40 hours per week (25% versus 9%, P = .049). There was no gender difference in income for fellowship-trained surgeons, but a disparity in income >200,000 dollars favored non-fellowship-trained men (74% versus 36%, P = .0031). Both genders reduced work hours. Women reduced them exclusively for personal/family demands. Both genders reported satisfaction with their surgical careers (93%). CONCLUSIONS: Some gender differences in surgery were identified. However, both genders maintain a high level of satisfaction with their career choice.

Career Choice↗

Gender differences in cardiac ACE expression are normalized in androgen-deprived male mice.

Gender differences have been described in the response of the cardiovascular system to a number of stimuli, including ventricular remodeling in response to pressure overload, but the molecular basis for these differences remains unclear. Because gender differences in the cardiac expression of angiotensin-converting enzyme (ACE) could contribute to differences in myocardial remodeling, we examined myocardial ACE expression in age-matched male and female mice. Ventricular ACE was more abundant in male than female mice at both mRNA and protein levels. These differences became apparent once the mice reached sexual maturity and became more pronounced with increasing age. The influence of mouse gonadal status on ventricular ACE expression was also examined. Oophorectomy slightly increased ACE levels in female mice, whereas ventricular ACE levels were substantially decreased in androgen-deprived males. The antithetical changes in ventricular ACE abundance seen in agonadal male and female mice suggest that testosterone as well as estrogen may play a role in regulating ACE expression in the heart.

Animals↗

Gender difference in cocaine-induced HPA axis activation.

The study investigates the influence of gender on the activation of the hypothalamo-pituitary-adrenal (HPA) axis by cocaine and other monamine uptake inhibitors. Drug-induced secretion of adrenocorticotrophic hormone (ACTH) was used to pursue this question. Cocaine produced a dose-related rise in serum ACTH levels in both male and female rats, but the rise was significantly greater in females than in males. Females also showed enhanced HPA axis activation following administration of the dopamine uptake inhibitor GBR 12909, the serotonin uptake inhibitor fluoxetine, and the norepinephrine uptake inhibitor desipramine. No gender difference in HPA axis activation was observed in a dose-response study of cocaine-induced HPA activation in 10 day old rats. Ovariectomy of females decreased the ACTH response to cocaine, but castration did not affect the response of males. To evaluate the role of the pituitary in this gender difference, ACTH levels were determined after corticotropin-releasing factor (CRF) administration. Females showed greater ACTH responses to CRF than males. These studies demonstrate that female rats show exaggerated HPA responses to monoamine uptake inhibitors and that enhanced pituitary responsivity to CRF contributes to this gender difference.

Adrenocorticotropic Hormone↗

Ethnic and gender differences in electrocardiographic QT length and QT dispersion in hypertensive subjects.

BACKGROUND: Prolonged QT intervals and/or increased QT dispersion (QTd) are associated with various pathological conditions and predict death in healthy individuals. Among hypertensives, QTd correlates with blood pressure (BP) and left ventricular mass index (LVMI) and QT intervals are prolonged in those with left ventricular hypertrophy (LVH). In normotensives, heart-rate corrected QT length (QTc) is longer in females than males, but QTd is greater in males than females. There are few data comparing QT parameters between different ethnic groups and none specifically in hypertensives. Among normotensives, compared with whites, QTc is reported to be shorter in African-Americans and longer in Chinese. We looked for ethnic and gender differences in QT parameters in hypertensive subjects. METHODS: Untreated hypertensives were selected from a Hypertension Clinic database. Black and white subjects were matched for age, sex, BP and LVMI. Male and female subjects were matched for age, race, BP and the presence or absence of echocardiographic LVH. Maximum QT intervals (QTm), rate-corrected maximum QT intervals (QTc) and QT dispersion (QTd) were measured or calculated from ECGs. Data are presented as mean +/- s.d. Differences in QT parameters were sought between groups using Student's t-tests. RESULTS: No ethnic or gender differences in QT parameters achieved statistical significance. However there was a tendency for QTm and QTc to be prolonged in blacks compared with whites (443 +/- 52 vs 421 +/- 47; P = 0.08 and 480 +/- 65 vs 463 +/- 40: P = 0.24 respectively), and for QTc to be prolonged in females compared with males (479 +/- 52 vs 461 +/- 45 ms; P= 0.13). CONCLUSION: In small groups of matched hypertensives, no ethnic or gender differences in QT parameters achieved statistical significance. However, similar to findings in normotensives, QTc tended to be longer in hypertensive females than males. In hypertensives, we failed to confirm the finding that QTc is shorter in blacks than whites, as seen in US normotensives. Whether this represents a difference between hypertensives and normotensives, or between US and UK blacks requires further investigation. Whether the prognostic significance of QT parameters in hypertensives differs between different gender and ethnic groups needs to be established from prospective studies. Journal of Human Hypertension (2000) 14, 403-405

Adult↗

Gender differences in the genetic factors responsible for variation in bone density and ultrasound.

Although genetic factors are thought to explain a large proportion of the variation in bone density in women, few studies have been conducted in men. Therefore, it is unclear whether the individual differences in bone strength between men and women are a reflection of gender differences in the relative influence of genetic and environmental factors on bone density variance. The aim of this study was to determine if there were gender differences in the genetic components of variance for bone density and ultrasound. In addition, the study aimed to explore the hypothesis that there are unique gender-specific genetic determinants of these traits. Bone mineral density (BMD) of the hip, distal forearm, and lumbar spine were measured by dual-energy X-ray absorptiometry (DXA) as well as quantitative ultrasound (QUS) at the calcaneus in healthy female twin pairs (286 identical [MZ] and 265 nonidentical [DZ]), male twin pairs (72 MZ and 65 DZ), and 82 opposite-sex (OS) pairs aged between 18 and 80 years. For hip BMD, distal forearm, and QUS measurements, the differences between MZ correlations and like-sex DZ correlations were similar for both sexes, suggesting little difference in the component of total variance explained by genetic factors between male and female twin pairs. However, correlations between OS twin pairs were lower than that of like-sex twin pairs, suggesting the possibility of unique gender-specific genetic effects. At the forearm, model fitting suggested a small gender difference in the magnitude of genetic variance as well as the presence of a unique gender-specific genetic variance component. Hip, lumbar spine, and QUS measurements were better explained by models that assumed no gender differences in genetic variance between the sexes, but the study had insufficient power to detect small differences in the genetic components of variance. The results of this study suggest that the proportion of bone strength variance explained by genetic factors is similar for men and women. However, at some regions there is evidence to suggest a gender-specific genetic component to the overall genetic variance.

Absorptiometry, Photon↗

The effectiveness of selected risk factors in mediating gender differences in drinking and it problems.

PURPOSE: The purpose of this study was to investigate gender differences in adolescents' alcohol use, adverse consequences of alcohol and other drug (AOD) use and the effectiveness of selected risk factors in mediating gender differences. METHODS: A cross-sectional survey design was adopted. Data were collected from a sample of high school students (n=919) in one midwestern community. Four criteria for examining potential mediated relationships were addressed. RESULTS: Expected differences in relation to males' higher levels of frequent and heavy drinking, adverse consequences of AOD use and risk factors were found. All risk factors were significantly related to adverse consequences, but alienation was not related to drinking behavior. In a one-way ANOVA, the main effects of gender were significant for both drinking behavior and adverse consequences of AOD use. In a two-way ANOVA, the main effects of a risk factor index reduced the main effects of gender substantially. CONCLUSIONS: Controlling risk factor levels mediates gender differences in the outcomes, drinking behavior and adverse consequences of AOD use.

Adolescent↗

Gender differences in adrenal cortex steroid production in SHR/N-corpulent rats.

Gender differences in adrenal steroid hormone production and serum steroid hormone levels were compared in the spontaneous hypertensive/NIH-corpulent (cp) rat, which exhibits characteristics of both obesity and non-insulin-dependent diabetes mellitus. The study demonstrated that adrenal gland size correlated with adrenal production and serum levels of steroid hormones. Obese female SHR/N-cp rats were more steroidogenic than male SHR/N-cp rats; the size of their adrenal glands was twice that of the males (70 vs 33 mg). Body weights averaged 666 g for females and 829 g for males. Obese female rats had significantly higher serum concentrations of both corticosterone (827 vs 536 ng/ml) and aldosterone (675 vs 482 pg/ml) than obese male rats. As determined by in vitro assay, adrenal cortex production of corticosterone (2157 vs 1435 ng/30 min) and aldosterone (13.3 vs 9.5 ng/30 min) was significantly higher in obese female than in obese male rats. Adrenal production of testosterone in the in vitro assay was also significantly higher for obese female than male rats; however, adrenal estrogen production in obese rats did not differ significantly. The type of carbohydrate consumed (sucrose > starch) significantly affected serum levels of corticosterone, but not aldosterone, testosterone, or estrogen. Gender differences in adrenal steroid production and serum steroid levels suggest that hyperglycemia in obese SHR/N-cp rats may be, in part, the result of excess adrenal production of steroid hormones.

Adrenal Cortex↗

Gender differences in the frequency and treatment of behavior problems in Parkinson's disease. SAGE Study Group. Systematic Assessment and Geriatric drug use via Epidemiology.

OBJECTIVE: To determine gender differences in the prevalence, survival rates, and management of noncognitive behavioral problems of patients with Parkinson's disease (PD) in nursing homes (NH). METHODS: We performed an observational study on 24,402 residents with PD using the Systematic Assessment and Geriatric drug use via Epidemiology (SAGE) database collected from the Minimum Data Set on a cross-section of over 400,000 NH residents in five US states. Gender differences in behavior were used to predict differences in pharmacologic and nonpharmacologic therapies using logistic regression. Similar analyses were done to evaluate gender differences in 1-year survival rates among patients with PD with and without behavioral problems. RESULTS: 36% of men and 33% of women exhibited behavioral problems. Wandering, verbal and physical abusiveness, and inappropriate behavior tended to be more common in men, especially among PD residents with severe cognitive impairment. Hallucinations and delusions were equally prevalent between genders and depressive symptoms were more common in women. Regardless of behavioral manifestation, men were more likely to receive antipsychotic drugs, whereas women were more likely to receive antidepressants. This gender difference in treatment was also widest among the severely demented group. Although women lived longer, no difference in survival curves were noted between PD residents with and without behavioral problems. CONCLUSION: Gender appears to play an important role in determining the frequency and treatment of behavioral problems of NH residents with PD.

Activities of Daily Living↗

Gender differences in pain.

A review of the literature on gender and clinical pain reveals a disproportionate representation of women receiving treatment for many pain conditions and suggests that women report more severe pain, more frequent pain, and pain of longer duration than do men. Gender differences in pain perception have also been extensively studied in the laboratory, and ratings of experimentally induced pain also show some sex disparity, with females generally reporting lower pain thresholds and tolerance than males. However, there is little consensus on whether these apparent differences reflect the way men and women respond to pain, differing social rules for the expression of pain, or biologic differences in the way noxious stimuli are processed. In this paper, our working hypothesis is that the higher prevalence of chronic orofacial pain in women is a result of sex differences in generic pain mechanisms and of as-yet unidentified factors unique to the craniofacial system. We will review the evidence concerning gender differences in the prevalence of pain conditions, with a focus on orofacial pain conditions. Evidence and hypotheses concerning biologic and psychosocial factors that could influence prevalence rates will also be discussed.

Chronic Disease↗

Gender differences in the cause of low back pain in British soldiers.

OBJECTIVES: To explore gender differences in the cause of low back pain in a population of military personnel who are expected to undertake high levels of sport, exercise and physical military training. METHODS: A prospective study of trained British soldiers, with symptomatic low back pain, referred to the Colchester Garrison Sports Injury and Rehabilitation Centre over a four year period. RESULTS: The study demonstrates that 928 (17.8%) of the 5214 referrals were for new cases of low back pain. The incidence of low back pain in female soldiers is higher than their male counterparts with an odds ratio of 3.17 (95% CI 2.31 - 4.35) There was a highly significant cross gender difference in low back pain caused by activities in the followining categories: military physical traininong (OR 2.65, 95% CI 1.70 - 4.02), work or occupation (OR 2.49, 95% CI 1.56 - 3.87) and off-duty pursuits (OR 2.91, 95% CI 1.72 - 4.72). There was no cross gender difference in low back pain caused by sport, road traffic accidents or activities pre-dating military service. CONCLUSIONS: Female soldiers are significantly more likely to suffer low back pain as a result of physical military training, their occupation, or off-duty activities. Sporting activities do not cause low back pain in women to a greater extent than men By demonstrating the scale of the problem and by determining of the cause of injury, it should now be possible to propose methods of effective intervention to reduce injury, implement those interventions and audit effectiveness.

Adult↗

Gender differences in skeletal muscle fatigability are related to contraction type and EMG spectral compression.

The purposes of this study were 1) to evaluate gender differences in back extensor endurance capacity during isometric and isotonic muscular contractions, 2) to determine the relation between absolute load and endurance time, and 3) to compare men [n = 10, age 22.4 +/- 0.69 (SE) yr] and women (n = 10, age 21.7 +/- 1.07 yr) in terms of neuromuscular activation patterns and median frequency (MF) shifts in the electromyogram (EMG) power spectrum of the lumbar and hip extensor muscles during fatiguing submaximal isometric trunk extension exercise. Subjects performed isotonic and isometric trunk extension exercise to muscular failure at 50% of maximum voluntary contraction force. Women exhibited a longer endurance time than men during the isometric task (146.0 +/- 10.9 vs. 105.4 +/- 7.9 s), but there was no difference in endurance performance during the isotonic exercise (24.3 +/- 3.4 vs. 24.0 +/- 2.8 repetitions). Absolute load was significantly related to isometric endurance time in the pooled sample (R(2) = 0.34) but not when men and women were analyzed separately (R(2) = 0.05 and 0.04, respectively). EMG data showed no differences in neuromuscular activation patterns; however, gender differences in MF shifts were observed. Women demonstrated a similar fatigability in the biceps femoris and lumbar extensors, whereas in men, the fatigability was more pronounced in the lumbar musculature than in the biceps femoris. Additionally, the MF of the lumbar extensors demonstrated a greater association with endurance time in men than in women (R(2) = 0.45 vs. 0.19). These findings suggest that gender differences in muscle fatigue are influenced by muscle contraction type and frequency shifts in the EMG signal but not by alterations in the synergistic activation patterns.

Adult↗

Gender differences in mortality after hip fracture: the role of infection.

UNLABELLED: Possible explanations for the observed gender difference in mortality after hip fracture were examined in a cohort of 804 men and women. Mortality during 2 years after fracture was identified from death certificates. Men were twice as likely as women to die, and deaths caused by pneumonia/influenza and septicemia showed the greatest increase. INTRODUCTION: Men are more likely to die after hip fracture than women. Gender differences in predisposing factors and causes of death have not been systematically studied. MATERIALS AND METHODS: Participants (173 men and 631 women) in the Baltimore Hip Studies cohort enrolled in 1990 and 1991, at the time of hospitalization for hip fracture, were followed longitudinally for 2 years. Cause-specific mortality 1 and 2 years after hip fracture, identified from death certificates, was compared by gender and to population rates. RESULTS AND CONCLUSIONS: Men were twice as likely as women to die during the first and second years after hip fracture (odds ratio [OR], 2.28; 95% CI, 1.47, 3.54 and OR, 2.21; 95% CI, 1.48, 3.31). Prefracture medical comorbidity, type of fracture, type of surgical procedure, and postoperative complications did not explain the observed difference. Greatest increases in mortality, relative to the general population, were seen for septicemia (relative risk [RR], 87.9; 95% CI, 16.5, 175 at 1 year and RR, 32.0; 95% CI, 7.99, 127 at 2 years) and pneumonia (RR, 23.8; 95% CI, 12.8, 44.2 at 1 year and RR, 10.4; 95% CI, 3.35, 32.2 at 2 years). The magnitude of increase in deaths caused by infection was greater for men than for women in both years. Mortality rates for men and women were similar if deaths caused by infection were excluded (3.46 [1.79, 6.67] and 2.47 [1.63, 3.72] at 1 year and 0.96 [0.48, 1.91] and 1.26 [0.80, 1.98] at 2 years). Deaths related to infections (pneumonia, influenza, and septicemia) seem to be largely responsible for the observed gender difference. In conclusion, an increased rate of death from infection and a gender difference in rates persists for at least 2 years after the fracture.

Aged↗

Gender differences in smoking cessation after 3 years in the Lung Health Study.

OBJECTIVES: An analysis of gender differences in smoking cessation was conducted among 3923 participants in the Special Intervention group of the Lung Health Study. This report focuses on gender differences in sustained quit rates at 12 and 36 months. METHODS: Special Intervention participants were offered a 12-session, 12-week smoking cessation program using nicotine gum and were followed for 3 years. Self-reported smoking status was validated with carbon monoxide and salivary cotinine. RESULTS: Men had higher sustained quit rates at 12 and 36 months; gender differences were found in baseline variables that also predicted sustained abstinence; and controlling for selected baseline variables reduced the association between gender and sustained abstinence. When other variables were controlled, gender predicted sustained abstinence at 36 months (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.04, 1.48) but not 12 months (OR = 1.08, 95% CI = 0.92, 1.27), reflecting more late relapse among women. CONCLUSIONS: Demographics and smoking history were more important than gender per se in sustained smoking cessation in the Lung Health Study. Programs tailoring smoking cessation by gender need to include coping skills for problems associated with less education and social support and for improving persistence with quit attempts.

Adult↗

Gender differences in chronic major and double depression.

BACKGROUND: While the sex difference in prevalence rates of unipolar depression is well established, few studies have examined gender differences in clinical features of depression. Even less is known about gender differences in chronic forms of depression. METHODS: 235 male and 400 female outpatients with DSM-III-R chronic major depression or double depression (i.e., major depression superimposed on dysthymia) were administered an extensive battery of clinician-rated and self-report measures. RESULTS: Women were less likely to be married and had a younger age at onset and greater family history of affective disorder compared to men. Symptom profile was similar in men and women, with the exception of more sleep changes, psychomotor retardation and anxiety/somatization in women. Women reported greater severity of illness and were more likely to have received previous treatment for depression with medications and/or psychotherapy. Greater functional impairment was noted by women in the area of marital adjustment, while men showed more work impairment. LIMITATIONS: Since our population consisted of patients enrolling in a clinical trial, study exclusion criteria may have affected gender-related differences found. CONCLUSIONS: Chronicity of depression appears to affect women more seriously than men, as manifested by an earlier age of onset, greater family history of affective disorders, greater symptom reporting, poorer social adjustment and poorer quality of life. These findings represent the largest study to date of gender differences in a population with chronic depressive conditions.

Adult↗