Gender Differences In Risk Factors Research Articles

Sex and gender differences in risk factors for posttraumatic stress disorder: A systematic review and meta-analysis of prospective studies.

Women are at higher risk than men for developing posttraumatic stress disorder (PTSD), but underlying mechanisms are still unclear. Comprehensive knowledge about these mechanisms is necessary to develop tailored, sex- and gender-sensitive preventive interventions. This systematic review and meta-analysis examined sex-/gender-dependent risk factors, that is, risk factors with sex/gender differences in (a) vulnerability or (b) prevalence/severity, as well as sex-/gender-specific risk factors, that is, and (c) risk factors present in one sex/gender only. We searched PubMed, Web of Science, PsycINFO, PsycArticles, and PSYNDEX for articles published until October 16, 2022. We included prospective studies that assessed risk factors to predict subsequent PTSD symptom severity, as measured with the Clinician-Administered PTSD scale. The primary outcomes were sex/gender stratified pooled for sex-/gender-dependent vulnerability and sex-/gender-specific risk factors and pooled odds ratio (OR) or standardized mean difference (SMD) for sex-/gender-dependent risk factor prevalence/severity. We screened 17,270 records and included 117 reports from 45 studies (N = 13,752) in the systematic review. Seventeen studies (N = 4,257; 1,827 women, 2,430 men) were included in the meta-analysis. Regarding risk factor vulnerability, analyses revealed no significant sex/gender differences except for acute stress symptoms, with stronger associations for men (b = 0.11, SE = 0.06, p < .05). Regarding risk factor prevalence/severity, women reported more severe immediate psychological stress responses (range SMD = 0.23-0.56) and more commonly had a history of mental illness (OR = 1.81, 1.27-2.58). Men showed higher trauma load (SMD = -0.15, -0.29 to 0.01). Few women-specific and no men-specific factors were identified. Results suggest that women's heightened immediate psychological stress response drives sex/gender disparities in PTSD symptom severity. Preventive interventions should thus target women early after trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Gender differences in risk factors for ischemic stroke: a longitudinal cohort study in East China

ObjectivesEpidemiological studies of stroke and its risk factors can help develop strategies to prevent stroke. We aimed to explore the current gender-specific prevalence of stroke and associated risk factors.MethodsData were collected using a structured precoded questionnaire designed by the Stroke Screening and Prevention Programme of the National Health and Wellness Commission Stroke Prevention and Control Project Committee, between June 2020 and November 2021. A total of 7394 residents took part in the study, 187 of whom had a stroke. The baseline information of each participant was obtained and included in this study. The chi-square test and Kruskal-Wallis tests were used to examine the relationship between these indicators and stroke, and then multivariate logistic regression was used to construct the prediction scale between different genders.Resultsof 7394 participants,4571 (61.82%) were female. The overall prevalence of stroke patients in the study population was 2.53%, Multivariate analysis found that residence status (OR = 0.43, p = 0.002) 、HCY (OR = 0.962, p = 0.000)、Previous TIA (OR = 0.200, p = 0.002) 、Hypertension (OR = 0.33, p = 0.000) and Dyslipidemia (OR = 0.668, p = 0.028) were significant predictors of stroke. there are gender differences in the traditional risk factors for stroke, and women have more risk factors. ROC analysis confirmed the accuracy of the stroke risk model, and the AUC of the stroke risk model for the general population was 0.79 with p < 0.05. In the gender model, the female AUC was 0.796 (p < 0.05). and the male AUC was 0.786 with p < 0.05.ConclusionThe prevalence of stroke in adults aged 40 years and above is high in eastern China were high. management of risk factors can effectively prevent the occurrence of most strokes. more attention should be paid to gender differences associated with stroke.

Supplemental Material for Sex and Gender Differences in Risk Factors for Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis of Prospective Studies

Supplemental Material for Sex and Gender Differences in Risk Factors for Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis of Prospective Studies

Gender differences in prevalence and clinical risk factors of suicide attempts in young adults with first-episode drug-naive major depressive disorder.

Suicide rates in adolescents with major depressive disorder (MDD) change with age and gender. Early adulthood is an important transitional stage between late adolescence and adulthood, in which an individual's mind gradually matures. However, there are fewer studies on prevalence and variables linked to the suicide attempts of young adults with MDD. To explore gender differences in the prevalence and risk factors associated with suicide attempts in young adults with first-episode drug-naive MDD. The Hamilton Rating Scale for Depression (HRSD), Hamilton Rating Scale for Anxiety (HRSA) and Positive Subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess depression, anxiety and psychotic symptoms respectively and various biochemical indicators were assessed. Among 293 young adults with first-episode drug-naive MDD, the prevalence of suicide attempts was 15.45% (19/123) for males and 14.12% (24/170) for females. Males with suicide attempts had higher levels of thyroid-stimulating hormone (TSH) and higher PANSS Positive Subscale scores, whereas females with suicide attempts had higher TSH, serum total cholesterol, fasting blood glucose and diastolic blood pressure levels and higher scores on the HRSD, HRSA, PANSS Positive Subscale (all Bonferroni corrected P < 0.05). In males, PANSS Positive Subscale score (B = 0.17, P = 0.03, OR = 1.19, 95% CI 1.02-1.38) was a risk factor for suicide attempts. There were significant gender differences in the risk factors for suicide attempts in young adults with first-episode drug-naive MDD.

Abstract 16129: The Gender Difference in Risk Factors and Incidence Rate of Ischemic Stroke in Japanese Atrial Fibrillation Patients: The Fushimi AF Registry

Background: Gender-specific medicine is of concern in cardiovascular medicine. We previously reported that there was not gender difference in the incidence of ischemic stroke from the Fushimi AF Registry. However, the gender difference in risk factors of ischemic stroke in Japanese atrial fibrillation (AF) patients is little known. The aim of this study is to compare the risk factors and incidence rate of ischemic stroke in male and female using the latest data with longer follow-up. Method: In the Fushimi AF Registry, follow-up data were available for 4,496 patients. In the entire cohort, 2,677 were male and 1,819 were female. We compared clinical characteristics and risk factors and incidence rate of ischemic stroke between the two groups. Result: Male patients were younger (male vs. female; 71.5 years vs. 76.7 years, p&amp;lt;0.01), greater in body weight (65.0 kg vs. 51.2 kg, p&amp;lt;0.01), were more often sustained type (52.0% vs. 48.2%, p=0.04), more likely to have diabetes mellitus (26.2% vs. 19.9%, p&amp;lt;0.01), coronary artery disease (16.0% vs. 12.3%, p&amp;lt;0.01) and less likely to have prior heart failure (24.0% vs. 32.3%, p&amp;lt;0.01), chronic kidney disease (CKD) (33.7% vs. 39.3%, p&amp;lt;0.01) and had lower CHADS 2 score (1.96 vs. 2.15, p&amp;lt;0.01). In prescription data, male patients more often received oral anticoagulant (58.2% vs. 52.1%, p&amp;lt;0.01) and antiplatelet drug (APD) (29.0% vs. 23.8%, p&amp;lt;0.01). Hypertension, left atrium enlargement (LAE), previous stroke and major bleeding were comparable between the two groups. During the median follow-up of 1,824 days (longest 10 years), the incidence rate of ischemic stroke was not significantly different between two groups (0.86 vs. 0.89% per person-year, log rank p=0.32). On multivariate Cox regression analysis, age, previous stroke and LAE were significantly associated with an increased risk of ischemic stroke in both groups. CKD and prescription of APD were significantly associated with an increased risk of ischemic stroke in male, while body weight was in female. Conclusion: The incidence rate of ischemic stroke was not significantly different between male and female. The risk factors associated with ischemic stroke were different between male and female in Japanese AF patients.

Abstract 238: Gender Differences In Clinical Factors In Obese Ischemic Stroke Patients With A History Of Smoking

Introduction Clinical risk factors and co‐morbidities in obese male and female ischemic stroke patients with a history of smoking may contribute to differing stroke outcomes. The objective of this study is to determine gender differences in risk factors in obese ischemic stroke patients with a history of smoking. Methods A retrospective study was conducted on 6‐year data from 5469 patients with an ischemic stroke event from a regional stroke center. A logistic regression model was used to predict clinical risk factors associated with male or female patients. Multicollinearity was assessed using variance inflation factors (VIFs), with values &gt;5 suggestive of multicollinearity Results In the adjusted analysis, (OR = 1.806, 95% CI, 1.028–3.174, P =0.040*), a history of drugs and alcohol (OR = 2.873, 95% CI, 1.349–6.166, P =0.006), Serum Creatinine (OR = 4.724, 95% CI, 2.171–10.281, P&lt;0.001), Age (OR = 1.024, 95% CI, 1.022–1.047, P=0.033), and systolic blood pressure (OR = 1.029, 95% CI, 1.011–1.047, P&lt;0.002) were associated with males. Depression (OR = 0.432, 95% CI, 0.244–0.764, P&lt;0.004), Previous TIA (OR = .319, 95% CI, 0.142–0.714, P&lt;0.005), and higher levels of HDL (OR = 0.938, 95% CI, 0.915–0.962, P&lt;0.001) were associated with female gender. Conclusion Gender differences were observed in the clinical factors and comorbidities within the population of AIS patients who were smoking and obese. Further studies should evaluate the effect of specific risk factors to develop specific strategies for the management of identified risk factors to improve the care of obese male and female ischemic stroke patients with a history of smoking.

Age and Sex Differences in Patients with Chronic Heart Failure

Introduction. The increasing burden of morbidity from heart failure, which is determined to be an age-related disease, new information about sex differences of this pathology determines the need of reviewing existing data on this problem particularly in older patients. The objective is to systematize data on gender differences in heart failure among older patients.Materials and methods. A search of literature for 2011–2023 was conducted in the PubMed, Cochrane Library, Embase, Google Scholar databases, eLibrary. Data on sex and age differences of heart failure was included. The preferred languages were Russian and English. During the initial search, 4,228 sources were found. Full-text peer reviewed journal publications with the results of randomized and non-randomized clinical trials, meta-analyses, systematic reviews, and observational studies were selected.Results and discussion. Gender differences in risk factors, epidemiology, pathophysiology, clinical manifestations, treatment of heart failure (HF), particularly in older and oldest-old patients were characterized. Presented information proves the need for a differentiated approach for managing patients of both sex with HF in advanced age.Conclusion. It is necessary to develop new scientific programs and clinical recommendations for the differentiated management of patients with HF, including older and oldest-old patients in order to improve the prognosis and quality of life.

Exploring gender differences in risk factors for self-harm in adolescents using data from the Millennium Cohort Study

BackgroundSelf-harm is common in young people and girls have consistently higher rates of self-harm than boys. Differences in exposure and reactions to risk and protective factors, adverse events and problematic interpersonal relationships, and levels of wellbeing could contribute to the gender difference. This study aims to explore gender differences in risk factors associated with self-harm, to provide the foundation for developing more gender-sensitive approaches to self-harm management. MethodsData were analysed from 11,196 young people recruited to the Millennium Cohort Study, surveyed around age 14. We examined gender differences in the prevalence of key psychological and social risk factors for self-harm, including family and peer relationships, emotional wellbeing, and bullying and victimisation. We utilised modified Poisson regression to estimate gender-specific risks. ResultsAt age 14 self-harm prevalence was 15.4 % with a ratio of 2.6 females to 1 male. Differential exposure to recorded psychosocial risk factors explained a third of the gender difference in risk of self-harm. Intense social media use and not confiding in family members were associated with a greater likelihood of self-harm in girls than boys. Bullying others and same-sex attraction were more strongly associated with self-harm in boys than girls. LimitationsSelf-harm data were obtained by self-report therefore subject to misclassification. The cross-sectional design does not enable us to establish causation. ConclusionsUnhappiness and dissatisfaction are common in adolescence. Our findings suggest the need for further research into young people's experiences to explore why rates differ and inform the development of gender-specific approaches to self-harm management.

Gender differences in risk factors for smokeless tobacco use: Insights from the latest nationally representative cross-sectional demographic and health survey (2019–2021) and their potential implications for smokeless tobacco control in the WHO South-East Asia region

Introduction: The global prevalence of Smokeless Tobacco (SLT) use is estimated to be 4.72%, concentrated in South East Asia. Despite declining smoking rates, SLT usage remains high, resulting in 2.5 million DALYs and 90,791 deaths in 2017 due to cancers and heart diseases, with India contributing 70% of DALYs. This study examines risk factors for SLT use in Indian males and females aged 15–49 using 2019–2021 demographic and health survey data, also exploring gender differences. Methods: The study analyzed a substantial sample of 724,115 females and 93,267 males utilizing data from a nationally representative cross-sectional demographic and health survey conducted between 2019 and 2021. Gender-specific multivariable logistic regression analyses were performed to identify risk factors influencing SLT use. Results: The findings reveal gender-specific variations in SLT use risk factors. Among males, older age groups (35–49) were less likely to use SLT compared to those aged 30–34. In contrast, among females, SLT use increased with age, with the highest rates in the 40–44 and 45–49 age groups. Marital status played a significant role, with widowed, divorced, and separated females having higher odds of SLT use compared to currently married females. Tribe ethnicity was associated with increased odds of SLT use in females but not in males. Christian females had higher odds of SLT use than Hindu females, while Christian males had lower odds compared to Hindu males. Conclusion: These findings provide valuable insights for policymakers, healthcare professionals, and public health advocates in developing targeted interventions to combat SLT use in South-East Asia. By addressing gender-specific risk factors and tailoring strategies to different populations, progress can be made in reducing the burden of SLT use and improving public health outcomes in the region.

Abstract P162: Gender Differences In Hypertension Risk Factors In Non-hispanic Asian Adults In The United States

Introduction: Hypertension (HTN) is a leading cause of comorbidity and mortality worldwide. Limited studies discussed the risk prediction for HTN prevalence among non-Hispanic Asian adults. We aim to examine gender differences in HTN prevalence and associations between risk factors and hypertension in non-Hispanic Asian adults in the US. Methods: We included non-Hispanic Asian adults (≥20 years) from the 2017-2018 National Health and Nutrition Examination Surveys. HTN was defined as blood pressure ≥140/90 mmHg or self-reported use of antihypertensive medication. We used hierarchical logistic regression to determine the odds of HTN diagnosis for different gender groups. Results: Among the 811 participants, 29.60% of men (111 of 375) and 28.90% of women (126 of 436) had HTN. The study found that the odds of HTN diagnosis increased with age for both men and women. Men aged 30-80 years had greater odds of HTN diagnosis compared to those aged 20-29 years, with odds ranging from 14.85 to 124.85. Women aged 50-80 years had greater odds of HTN diagnosis compared to those aged 20-29 years, with odds ranging from 22.74 to 67.33 (Table). Body mass index was a stronger predictor of HTN among women than men. In men, a higher waist-to-height ratio was associated with increased odds of HTN diagnosis. In women, higher fasting blood glucose and serum uric acid levels were stronger predictors of HTN. Conclusion: This study discovered substantial gender differences in the risk factors for HTN among non-Hispanic Asian adults living in the United States, with age shown to be a major risk factor.

Stroke in women: experience in a developing country

BackgroundSeveral studies have addressed gender differences in stroke. Yet, results are diverse, and research is still required in different populations. So, this study investigates variation in stroke according to gender in a developing country.MethodsThis is a registry-based, retrospective observational cross-sectional study comparing men and women as regards age, risk factors, stroke severity, quality of services, and stroke outcome.ResultsData analyzed comprised 4620 patients. It was found that men outnumbered women, while women had an older age, more prevalence of hypertension and atrial fibrillation, with severer strokes and worse outcomes. However, there was no gender difference in promptness nor frequency of administration of revascularization therapies.ConclusionDespite the gender difference in risk factors and stroke severity, we could not detect any significant disparity in acute stroke services provided to either gender. Among age categories in women, we identified differences in acute ischemic stroke subtypes, and acute management in favor of older age.

Gender differences in risk exposures for acute hepatitis C infection in Taiwan: a nationwide case–control study

BackgroundIn Taiwan, medical providers are required to report all acute hepatitis C (AHC) patients to National Notifiable Disease Surveillance System (NNDSS). Identifying factors associated with AHC may inform the strategies to prevent the spread of hepatitis C virus (HCV). We used the national surveillance data to assess gender difference in risk factors associated with AHC in Taiwan and propose control measures in at-risk groups.MethodsWe conducted a nationwide case–control study using data from NNDSS and AHC case investigation questionnaires, for the period of March 6, 2014–December 31, 2016. Cases were AHC confirmed in NNDSS; controls were reported AHC with negative HCV nucleic acid test and negative serum anti-HCV antibody. We used bivariate analysis to identify characteristics and risk exposures for AHC and conducted gender stratified analyses.ResultsWe identified 602 AHC cases (66.9% males, median age 48 years) and 90 controls. Older age, male gender (OR: 1.85, 95% CI: 1.18–2.90), history of viral hepatitis (OR: 7.93, 95% CI:1.91–32.88), history of sexually transmitted infections (OR: 21.02, 95% CI: 2.90–152.43), and having healthcare-associated risk exposures (OR: 2.02, 95% CI: 1.25–3.25) were associated with AHC. Stratified analyses showed receiving intravenous infusion, history of hepatitis B, syphilis, and human immunodeficiency virus infection were risk factors for male AHC; receiving hemodialysis was risk factor for females.ConclusionsOur study demonstrates risk factors for AHC in Taiwan with gender difference. Proper infection control practices in healthcare settings and interventions targeting male patients with HIV and other STIs, remain crucial to prevent individuals from AHC.

Gender Differences in Risk Factors for Dyslipidemia in the Khmer Ethnic People, Vietnam.

The majority of the Khmer ethnic people living in the Mekong Delta had a difficult socioeconomic life and limited access to information and health services. The study was conducted to determine the prevalence of dyslipidemia and risk factors in men and women of the Khmer ethnic people, in Vietnam. A cross-sectional study was conducted on 1.800 Khmer people aged 25 - 64 yr living in Tra Vinh Province in the Mekong Delta region of Vietnam. Data were analyzed using descriptive statistics and multivariate logistic regression. The prevalence of dyslipidemia was high in men (47.3%) and in women (51.4%). Men had a higher prevalence of high TG (28.9% vs. 23.9%), whereas the prevalence of high TC (34.1% vs. 42.4%), and high LDL-C (28.2% vs. 37.9%) were lower in women, (all P<0.05). In men, dyslipidemia was significantly associated with central obesity (OR=2.58, 95% CI=1.32-5.06), overweight/obesity (OR=2.50, 95% CI=1.75-3.56), and diabetes (OR=2.15, 95% CI=1.22-3.78). In women, dyslipidemia was significantly associated with diabetes (OR=2.14, 95% CI=1.08-4.24), central obesity (OR=1.69, 95% CI=1.18-2.42), overweight/obesity (OR=1.50, 95% CI=1.06-2.10), and hypertension (OR=1.43, 95% CI=1.03-1.99). Age was significantly associated with increased risk of dyslipidemia in both genders. Overall, the prevalence of dyslipidemia among Khmer men and women adults aged 25 - 64 years in Vietnam was high. Our findings indicated an urgent need to have dyslipidemia prevention intervention programs for the Khmer ethnic people in the Mekong Delta, especially training about obesity and increasing healthy lifestyles.

Gender disparities in ventricular tachycardia: evaluating clinical outcomes and interventions

Abstract Background Gender differences in the etiology of ventricular arrhythmia are well-known and can potentially affect clinical outcomes. Women have been under-represented in studies investigating ventricular tachycardia (VT). Thus, gender differences in clinical outcomes of VT are poorly defined. Purpose We sought to elucidate the clinical outcomes and interventions among women with VT. Methods We used the National Inpatient Sample to identify patients aged 18 and older admitted with VT from 2011 to 2019. Observations missing data on age, sex and mortality were excluded. Baseline characteristics include age, race, and comorbidities related to cardiovascular disease. Severity of comorbidities was assessed via the Deyo-Charlson Comorbidity Index (Deyo-CCI) score. Outcomes investigated include all-cause mortality, major adverse cardiovascular events (MACE), and incidence of catheter ablation, cardioversion, and automated implantable cardioverter defibrillator (AICD) insertion. Gender and outcomes association were analyzed using multivariable logistic regression adjusted for baseline characteristics that were significantly different (P&amp;lt;0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations. Results Between 2011 and 2019, there were an estimated 3,544,445 hospital admissions for VT, of which, 33.8% were women, who were more likely to be older (69.2 vs 68.0 years) and of minority descent (30.3% vs 26.7%) compared to men. Women were less likely to have coronary artery disease (43.5% vs 62.2%) or ischemic cardiomyopathy (5.0% vs 11.9%) and had a lower mean Deyo-CCI score (2.2 vs 2.4; p&amp;lt;0.001 for all). Women had a higher incidence of mortality (10.6% vs 9.2%) and ischemic stroke (5.3% vs 4.5%), but less acute coronary syndrome (17.6% vs 21.4%; p&amp;lt;0.001 for all). Overall incidence of MACE was lower among women (28.6% vs 31.4%; p&amp;lt;0.001). Multivariate regression analysis demonstrated that female sex remained independently associated with increased odds for all-cause mortality (aOR: 1.089; 95% CI: [1.062–1.116], p&amp;lt;0.001) although decreased odds for MACE (aOR: 0.952; 95% CI: [0.939–0.965]). Female sex was also independently associated with decreased odds for cardioversion (aOR: 0.936; 95% CI: [0.910–0.963]), AICD insertion, (aOR: 0.737; 95% CI: [0.711–0.764]) and ablation (aOR: 0.806; 95% CI: [0.766–0.847]; all p&amp;lt;0.001). Conclusion In this retrospective analysis of patients hospitalized with VT, women had less coronary artery disease and less MACE, yet all-cause mortality was higher. Female sex was also independently associated with fewer interventions, including AICD insertion and ablation. Although there are gender differences in risk factors and causes of VT, this does not fully explain disparities in care and outcomes. Further studies are needed to explore and elucidate these gender disparities. Funding Acknowledgement Type of funding sources: None.

Gender differences in risk factors and psychosocial functioning in children with psychogenic nonepileptic seizures

ObjectiveFemale predominance is evident in childhood-onset psychogenic nonepileptic seizures (PNES). Understanding gender-specific vulnerability to PNES may provide a unique insight into its cause and management. We aimed to investigate gender differences in demographic characteristics, triggering factors and psychosocial functioning in children and youth with PNES. MethodsWe retrospectively reviewed patients who were evaluated in the PNES clinic at Children’s Healthcare of Atlanta from July 2019 to March 2020 and completed questionnaires to assess adverse life events, psychosocial function (Pediatric Symptom Checklist-17 [PSC-17]), and somatic symptoms (Children’s Somatic Symptom Inventory-8, [CSSI-8]). ResultsForty-nine consecutive patients (38 girls, 11 boys) with a median age of 15.0 (9–19) years were included in the study. We performed univariate analysis and evaluated significant variables related to PNES according to sex. Majority of both genders experienced daily to weekly PNES, came from dysfunctional families, scored high on PSC-17, were treated for neuropsychiatric illnesses, and experienced bothersome somatic symptoms. The variables significantly different between genders were suicidal thoughts, history of trauma, and learning disability. Suicidal thoughts and trauma, particularly sexual abuse, were significantly more prevalent in girls (p = 0.03) whereas learning disability was more common in boys (p = 0.03). ConclusionFemales predominated in our PNES clinic (F:M = 3.5:1). Gender differences in predisposing factors were sexual abuse in females and learning disability in males. Our data highlight the gender-specific risk factors and vulnerability to PNES. The awareness of gender difference may guide more targeted intervention for children and youth with PNES.

Gender differences in risk factors for the 2year development of sarcopenia in community-dwelling older adults.

BackgroundSarcopenia is an age‐related chronic condition that can lead to mobility disabilities. This study aimed to evaluate the risk factors for incident sarcopenia in older Korean adults.MethodsThe Korean Frailty and Aging Cohort Study (KFACS) is a multicentre prospective study with a baseline examination in 2016–2017. A prospective follow‐up study was conducted in 2018–2019. Changes in muscle‐related variables were evaluated for subjects aged 70–84 years lacking sarcopenia at baseline. Sarcopenia was diagnosed according to the 2019 updated Asian Working Group for Sarcopenia consensus.ResultsAmong the 1636 participants (54.4% women, age 75.9 ± 3.7) who did not have sarcopenia at baseline, 101 men (13.5%) and 104 women (11.7%) developed sarcopenia by the follow‐up. Those who developed sarcopenia were older (men, 77.9 ± 3.9 vs. 75.7 ± 3.5, P < 0.001; women, 77.5 ± 4.0 vs. 75.5 ± 3.6, P < 0.001) with a lower body mass index at baseline (men, 23.9 ± 2.4 vs. 24.5 ± 2.9 kg/m2, P = 0.025; women, 23.7 ± 2.8 vs. 25.2 ± 2.9 kg/m2, P < 0.001) compared with older adults who remained nonsarcopenic; levels of glycated haemoglobin (men, 6.2 ± 1.0% vs. 5.9 ± 0.8%, P = 0.029) and the homeostasis model assessment of insulin resistance (men, 2.0 ± 1.3 vs. 1.7 ± 1.2, P = 0.022) were higher in men who progressed to sarcopenia but not in women. Development of sarcopenia was associated with older age and the frequency of resistance training (≥2 per week) after adjusting for potential risk factors in men [age, odds ratio (OR) 1.17, 95% confidence interval (CI) 1.10–1.25; frequent resistance training, OR 0.50, 95% CI 0.30–0.82]. In women, advanced age, poor nutritional status, and physical inactivity contributed to the development of sarcopenia (age, OR 1.14, 95% CI 1.08–1.21; mini nutritional assessment short form, OR 0.79, 95% CI 0.70–0.90; moderate to high physical activity, OR 0.57, 95% CI 0.34–0.95).ConclusionsIn this 2 year KFACS follow‐up, modifiable risk factors for incident sarcopenia differed between genders. Resistance training (≥2 per week) helped to prevent sarcopenia in these community‐dwelling older men. In older women, adequate nutritional support and being physically active might play a role in preventing progression to sarcopenia.

Risk factors associated with the occurrence of total knee arthroplasty in patients with knee osteoarthritis: a nested case-control study.

Objectives:The aim of this study was to investigate changes over time in osteoarthritis risk factors most closely associated with the occurrence of total knee arthroplasty (TKA). We hypothesize that the robustness of a longitudinal case–control study will provide new information on the association between changes in various clinical and structural parameters in different time frames before TKA.Methods:Cases (195; TKA after cohort entry) and controls (468) matched for age, gender, income, WOMAC pain, Kellgren–Lawrence grade and follow-up duration were from the Osteoarthritis Initiative cohort. Associations between changes in sociodemographic, clinical, imaging and osteoarthritis therapies with the occurrence of TKA were performed using conditional logistic regression analyses.Results:Worsening of WOMAC scores (cOR 1.02–1.20, p ⩽ 0.012), KOOS (1.02–1.04, p ⩽ 0.014), knee injuries sustained in the previous 30–40 years (women 2.70, p = 0.034) and valgus alignment (1.10, p = 0.052) were associated with the occurrence of TKA. Also associated with TKA was cartilage volume loss in the lateral (overall 1.76, p = 0.025; women 1.93, p = 0.047) and medial compartments (⩾10%, overall 1.54, p = 0.027; men 2.34, p = 0.008), occurrence of medial meniscal extrusion (overall 1.77, p = 0.046; men 2.86, p = 0.028), and increase in bone marrow lesions (BMLs) for women (1.09, p = 0.048). The association of risk factors with TKA was reinforced when both an increase in WOMAC pain and cartilage volume loss (1.85, p = 0.001) were combined. Pain medication usage, mainly narcotics and intra-articular steroid injections (IASI), was also associated with TKA, with no impact on changes in cartilage loss or structure.Conclusion:This study provides new information about gender differences in risk factors associated with the occurrence of TKA. Worsening of valgus alignment, cartilage volume loss in the lateral compartment, BMLs and older injuries are important risk factors in women, while medial compartment cartilage loss and meniscal extrusion are in men. The use of pain medication and IASI although associated was found not causal with TKA.

Gender Differences Between Domestic Violent Men and Women: Criminogenic Risk Factors and Their Association With Treatment Dropout.

Although many studies have concluded that men and women engage in domestic violence at equal levels, existing studies have hardly focused on gender specific risk factors for domestic violence perpetration. Therefore, this study aimed to examine gender differences in criminogenic risk factors between Dutch male and female forensic outpatients who were referred to forensic treatment for domestic violence. Clinical structured assessments of criminogenic risk factors were retrieved for 366 male and 87 female outpatients. Gender differences were not only found in the prevalence and interrelatedness of criminogenic risk factors, but also in associations between criminogenic risk factors and treatment dropout. In men, risk factors related to the criminal history, substance abuse, and criminal attitudes were more prevalent than in women, whereas risk factors related to education/work, finances, and the living environment were more prevalent in women. Further, having criminal friends, having a criminal history, and drug abuse were associated with treatment dropout in men, whereas a problematic relationship with family members, housing instability, a lack of personal support, and unemployment were associated with treatment dropout in women. Finally, network analyses revealed gender differences in risk factor interrelatedness. The results provide important insights into gender specific differences in criminogenic risk factors for domestic violence, which support clinical professionals in tailoring treatment to the specific needs of male and female perpetrators of domestic violence.

Does Gender Influence the Effectiveness and Safety of Insulin Glargine 300 U/ml in Patients with Uncontrolled Type 2 Diabetes? Results from the REALI European Pooled Analysis.

IntroductionGender differences in risk factors and treatment outcomes for type 2 diabetes mellitus (T2DM) may exist. We used the REALI European database to investigate whether there were gender-specific differences in baseline characteristics and clinical outcomes among patients with inadequately controlled T2DM initiated on insulin glargine 300 U/ml (Gla-300).MethodsData were pooled from 14 multicentre, prospective, interventional and non-interventional studies. Impact of gender on glycaemic control, insulin dose, body weight and hypoglycaemia was evaluated after 12 and 24 weeks of Gla-300 treatment.ResultsWomen (N = 3857) were older than men (N = 4376) (median age, 65.0 versus 63.0 years), with greater mean body mass index (32.5 versus 31.6 kg/m2) and lower median estimated glomerular filtration rate (77.5 versus 84.0 ml/min/1.73 m2). Peripheral arterial disease and a history of myocardial infarction were more frequent in men (20.1% versus 11.7% and 12.0% versus 5.8%, respectively). At baseline, mean haemoglobin A1c (HbA1c) was 8.74% in men and 8.79% in women. Least square (LS) mean (95% CI) reduction in HbA1c from baseline to week 24 was − 1.17% (− 1.21 to − 1.13) in men and − 1.07% (− 1.11 to − 1.02) in women, resulting in a LS mean difference of − 0.10% (− 0.15 to − 0.05; p < 0.0001). At 24 weeks, 21.6% of women and 27.2% of men achieved target HbA1c of < 7.0% (p < 0.001; chi-square). Reported incidence for symptomatic (8.5% versus 8.7%) and severe (0.3% versus 0.5%) any-time-of-the-day or symptomatic (2.4% versus 1.8%) and severe (0.1% versus 0.2%) nocturnal hypoglycaemia was overall low and comparable between men and women. Changes in daily Gla-300 dose and body weight were also similar.ConclusionDespite some gender differences in baseline characteristics, Gla-300 treatment improved glycaemic control, with overall low hypoglycaemia incidences in both men and women. However, women had statistically significantly lower HbA1c reductions than men, although these differences were clinically modest.

Gender-differences in outcomes of patients in Intensive Care Unit: findings from the SPINUTI network

Abstract Background Achieving gender equality is one of the most important Sustainable Development Goals to guarantee health and wellbeing worldwide. Here, we aimed to assess gender-differences in risk factors and outcomes among patients admitted to Italian Intensive Care Units (ICUs). Methods Here, we included 12,534 patients from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” (SPIN-UTI) project, who stayed in ICU for more than 48 hours. Firstly, characteristics at ICU admission were compared between males and females using the Mann-Whitney U or the Chi-Squared tests. Next, we compared the probability of death between genders by applying a logistic regression analysis. Results were adjusted for covariates (i.e., age, patient's origin, trauma, non-surgical treatment for acute coronary disease, surgical intervention and presence of intubation) and reported as Odds ratio (OR) and 95% Confidence Interval (CI). Finally, the Kaplan-Meier analysis was applied to assess gender difference in survival. Results Compared with male patients, females were older, more likely to come from other wards or healthcare facilities and to undergo a surgical intervention (p-values&amp;lt;0.05). By contrast, they were less likely to be intubated or traumatized and to undergo non-surgical treatment for acute coronary disease (p-values&amp;lt;0.05). Interestingly, a higher proportion of deaths was reported in female patients (p &amp;lt; 0.001), so that their odds of dying was 13% higher than males (OR = 1.13; 95%CI=1.00-1.28; p = 0.046) after adjusting for covariates. Accordingly, females reported lower survival in ICU than males (median= 32.0 days vs. median= 34.0 days; p &amp;lt; 0.001). Conclusions Our results pointed out gender-differences in patients' characteristics at ICU admission, which resulted into a higher risk of death and lower survival among females. In a Public Health point of view, these findings underline that is still important to sustain gender equality in ICUs and other hospital wards. Key messages There are several gender-differences in risk factors and outcomes among patients admitted to ICUs. Gender poses per se a higher risk for death in ICU, also considering other risk factors.