Factors associated with gender difference in the intima–media thickness of the common carotid artery
Introduction
Gender differences exist in many diseases and medical conditions. In premenopausal women, the incidence and severity of hypertension, stroke, and other vascular diseases are lower than in men at similar ages or than in post-menopausal women.1 Gender differences further exist in intermediate vascular risk factors, such as the intima–media thickness (IMT) of the common carotid artery (CCA), which is frequently used as a surrogate marker for subclinical atherosclerosis in multiple epidemiological and interventional studies.2, 3, 4
The pathophysiological mechanisms for these gender differences are still poorly understood, although emerging evidence suggests that sex hormone-dependent differences in vascular oxidative stress may play an important role.5, 6, 7 As gender is an unmodifiable risk factor for vascular diseases and the benefit of hormone-replacement therapy in women remain uncertain,8, 9 investigating for other factors than sex hormone-related differences may contribute to a greater understanding of the process of atherosclerosis.
The aim of the present study was to explore the factors associated with a thinner IMT in women.
Section snippets
Study design
This was a single-centre, observational study. The study hospital was a medical centre and a main referral hospital serving an area with 3 million inhabitants. The institutional ethics committee approved the study protocol, and informed written consent was obtained from each of the participants.
Subjects
From July 2006 to May 2007, a total of 218 consecutive volunteers (110 men and 108 women; age 18–65 years; mean age for men: 36.4 years; women: 37.7 years) who underwent an annual physical check-up were
CCA IMT is thinner in women
Table 1 presents the baseline characteristics of the 218 participants. Univariate analysis revealed that the mean IMT of the left CCA and the mean CCA IMT of both sides were significantly thinner in women than in men. In both women and men the left CCA IMT was thicker than the right CCA IMT (mean ± standard deviation; 0.556 ± 0.10 mm versus 0.529 ± 0.09 mm, p = 0.004).
Differences in demographic data and vascular risk factors between both genders
Univariate analysis (Table 1) revealed that blood pressure, fasting blood sugar, BMI, LDL-C, triglycerides (TG), homocysteine, uric acid,
Discussion
In accordance with the findings from multiple, large-scale, epidemiological studies,2, 3, 4 the present study revealed a thinner CCA IMT in women than in men in a Taiwanese population. Although the majority of those well-established vascular risk factors, which were analysed in the present study, differ significantly between men and women, only serum levels of HDL-C, homocysteine, uric acid, and TBARS as an indicator of lipid peroxidation were significantly associated with female gender in a
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