Risk Factors In Men Research Articles

The effect of patient's gender on the results of managing cardiovascular risk factors using specialized software

Objectives to assess the effect of the gender of patients on the severity of risk factors for the development of cardiovascular diseases using specialized software.
 Material and methods. In order to identify and correct the severity of risk factors for the development of cardiovascular diseases in the population, in 2018-2019, the data of residents of the Republic of Tatarstan were registered in specialized software. The severity of risk factors was assessed before the start of the study and after one year. The research included two groups of persons: men and women.
 Results. In 2018, the program "Cardiovascular Risk Management" had registered the data of 32,746 residents of the Republic of Tatarstan aged from 18 to 80 years. The risk factors for the development of cardiovascular diseases were identified in 22,999 individuals, where there were 7,188 men and 15,712 women. The patient's data included gender, age, history of coronary artery disease, smoking, physical activity, blood pressure, the levels of cholesterol, glucose and blood creatinine. The data on the severity of the risk factors in both groups were statistically processed. Based on the data obtained, the supervised persons received recommendations for correcting their lifestyle. In 2019, an assessment of the severity of risk factors was carried out in persons included in the system in 2018.
 Conclusion. We found a statistically significant difference in the results of managing risk factors in men and women. The software "Management of cardiovascular risks" is recognized as an effective tool for managing risk factors for the development of cardiovascular diseases and reducing mortality from diseases of the circulatory system.

Gender differences in cardiometabolic risks among young adults

Aim. To carry out a comparative assessment of cardiometabolic risk factors in men and women aged 18–44 years.Methods. The cross-sectional study included 251 patients divided into 2 groups. Group 1 consisted of 124 men; group 2 had 127 women in it. All participants of the study underwent anamnesis collection, blood pressure measurement, and assessment of anthropometric parameters, physical examination, biochemical and immunological tests.Results. The most significant gender differences were noted in the levels of leptin and adiponectin, fibrinogen and plasminogen activator inhibitor type 1, angiotensin II and interleukin-10 in the blood serum with no differences in cardiometabolic risk factors, including glucose and lipid metabolism.Conclusion. The revealed features of changes in adipokines and cytokines, indicators of hemostasis and vasoconstrictors in men and women expand the current knowledge about the role of some pathophysiological mechanisms in the development of cardiovascular pathology at a young age in the context of cardiometabolic risk concept.

761Characterisation and clustering of diseases by their association with well-known risk factors

Abstract Background Data-driven classifications are improving statistical power, refining prognoses, and improving our understanding of autoimmune, respiratory, infectious, and neurological diseases. Classifications have used molecular information, age of incidence, and sequences of disease onset (“disease trajectories”). Here we consider whether associations with easily-measured established risk factors such as height and BMI can usefully characterise disease. Methods UK Biobank data and their linked hospital episode statistics were used to study 172 common age-related diseases. A proportional hazards model was used to estimate associations with potential risk-factors and to adjust for well-known confounders. Diseases were compared and hierarchically clustered using novel but rigorous multivariate statistical methods. Results For diseases affecting both sexes, over 38% can be uniquely identified by their associations with risk factors. Equivalent diseases often clustered adjacently. After an FDR multiple-testing adjustment, roughly 5% have statistically significant differences. Similar remarks applied to several symptoms of unknown cause. Many clustered diseases are associated with a shared, known pathogenesis, others suggest likely but unconfirmed causes. Conclusions Risk factors for disease can be surprisingly precise and can be used to cluster diseases in a meaningful way. Risk factors for men and women may differ for some diseases. Several symptoms of unknown cause have disease-specific, statistically significant risk factors. Key messages Big datasets and modern statistics are providing new insights into the relationships between diseases and their associations with risk-factors. Diseases can be identified and clustered by their associations with well-known risk factors.

Educational inequalities, urbanicity and levels of non-communicable diseases risk factors: evaluating trends in Argentina (2005\u20132013)

BackgroundWe investigated a) whether urbanicity is associated with individual-level non-communicable diseases (NCD) risk factors and whether urbanicity modifies trends over time in risk factors; and (b) whether educational inequalities in NCD risk factors change over time or are modified by province urbanicity.MethodsWe used data from three large national surveys on NCD risk factors (Encuesta Nacional de Factores de Riesgo; ENFR2005–2009-2013) conducted in urban areas of Argentina (n = 108,489). We used gender-stratified logistic random-intercept models (individuals nested within provinces) to determine adjusted associations of self-reported individual NCD risk factors (hypertension, diabetes, obesity, and current smoking) with education and urbanicity.ResultsIn both men and women, the prevalence of obesity and diabetes increased over time but smoking decreased. Hypertension prevalence increased over time in men. Higher urbanicity was associated with higher odds of smoking and lower odds of hypertension in women but was not associated with NCD risk factors in men. Obesity increased more over time in more compared to less urbanized provinces (in men) while smoking decreased more over time in less urbanized provinces. All risk factors had a higher prevalence in persons with lower education (stronger in women than in men), except for diabetes in men and smoking in women. Educational inequalities in obesity (in men) and hypertension (in men and women) became stronger over time, while an initial inverse social gradient in smoking for women reverted and became similar to other risk factors over time. In general, the inverse associations of education with the risk factors became stronger with increasing levels of province urbanicity.ConclusionIncreasing prevalence of diabetes and obesity over time and growing inequities by education highlight the need for policies aimed at reducing NCD risk factors among lower socioeconomic populations in urban environments in Argentina.

Impact of Lisinopril on Cardiometabolic Risk Factors in Men With Hypertension and Early-onset Androgenetic Alopecia: A Pilot Study.

Women with polycystic ovary syndrome are at a high cardiometabolic risk. Early-onset male-pattern baldness is considered the phenotypic equivalent of polycystic ovary syndrome in men. The aim of this study was to assess whether early-onset androgenetic alopecia modifies cardiometabolic effects of lisinopril in men with arterial hypertension. The study population consisted of 62 young men with grade 1 hypertension, 31 of whom were diagnosed with early-onset male-pattern baldness (group A). Thirty-one blood pressure-matched men with normal hair growth (group B) served as a control group. All participants were treated with lisinopril (10-40 mg daily). Blood pressure, glucose homeostasis markers, urinary albumin-to-creatinine ratio (UACR), as well as plasma levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, total and calculated free testosterone, dehydroepiandrosterone sulfate, and estradiol were assessed before lisinopril treatment and 6 months later. At baseline, levels of all cardiometabolic risk factors were higher in group A than group B. Although lisinopril reduced systolic and diastolic blood pressure, UACR, hsCRP, and fibrinogen in both study groups, these effects were stronger in group B than in group A. Only in group B, the drug decreased levels of uric acid and homocysteine, as well as improved insulin sensitivity. The impact of lisinopril on uric acid, hsCRP, fibrinogen, homocysteine, and UACR correlated weakly with its hypotensive properties, androgen levels, and insulin sensitivity. The obtained results suggest that cardiometabolic effects of lisinopril in men are less pronounced in case of coexisting early-onset androgenetic alopecia.

Features of the structure of cardiovascular diseases risk factors for complicated myocardial rupture myocardial infarction in young and middle-aged men

AIM: Myocardial rupture currently remains in most cases a fatal complication of myocardial infarction.
 OBJECTIVE: To study the features of the structure of cardiovascular risk factors in men under 60 years old with complicated myocardial infarction to improve prevention.
 MATERIALS AND METHODS: The study included men 1960 years old with type I myocardial infarction. The patients were divided into two groups age-comparable: I studied, with myocardial rupture seven patients; II control, without breaks 558 patients. A comparative analysis of the frequency of observation of the main and additional factors of cardiovascular risk in the selected groups was performed.
 RESULTS OF THE STUDY: In the patients of the study group, frequent (four or more times a year) colds were observed more often than in the control group (42.9 and 14.8%, respectively; p = 0.04), the internal organs foci of infections (85.7 and 40.3%; p = 0.049), bypass surgery (57.1 and 10.2%; p 0.0001) and continuous cardiac pacing (28.6 and 0.5%; p 0.0001) in medical history. The presence of arterial hypertension (28.5 and 67.6%; p = 0.03) and foci of oral cavity infections (0 and 20.3%; p = 0.049) reduced the risk of myocardial rupture. In the study group, the levels of total cholesterol (4.3 0.3 and 5.8 1.2 mmol/l); p = 0.02), low-density lipoproteins (2.7 0.1 and 4.2 1.2 mmol/l); p = 0.04) and triglycerides (0.7 0.1 and 2.6 1.8 mmol/l); p = 0.008) were lower than in the control.
 CONCLUSION: Combinations of these cardiovascular risk factors indicate an increased risk of myocardial rupture. It is advisable to use them for predictive modeling of this event and the formation of risk groups for the purpose of timely prevention, (bibliography: 18 refs.).

The relationship between lipotoxicity and risk of extrathyroidal extension in papillary thyroid microcarcinoma.

To explore the relationship between triglyceride (TG) levels and aggressive pathological characteristics in papillary thyroid microcarcinoma (PTMC) patients, especially the relationship between TG, BMI, age, and extrathyroidal extension (ETE). A retrospective analysis of 9663 patients with PTMC in a single center from 2010 to 2017 was included in this study. Binary logistic regression was used to analyze the relationship between serum TG and aggressive pathological characteristics of PTMC in different genders. Further analyzing the risk of high TG in different ages and BMI groups. Even after adjustment for confounding factors, high TG is still a risk factor for ETE in women with PTMC, but not a risk factor for men. Compared with the group with lower than 0.90 mmol/L, when the TG level is higher than 1.93 mmol/L, the risk of ETE in women increased by about 1.35-fold. The remaining two variables (BMI, age) as risk factors for ETE are analyzed. In the normal BMI group, high TG is still a risk factor for ETE. The risk of ETE in women more than 55 years old is significantly increased by 1.96-fold (1.34-fold in less than 55 years). High TG in women is positively correlated with the risk of ETE in PTMC. PTMC with high TG in elderly women (more than 55 years) has a higher risk of ETE. TG is a potential serological index for predicting the risk of ETE in women with normal BMI.

Suicide attempts among people who use drugs: a comparative gender-based analysis using the ANRS-Coquelicot survey in France

Objective There exists no national French study on suicide attempts among people who use drugs (PWUD). Our objectives are to analyze lifetime suicide attempts in that population and to compare associated risks based on gender. Method The ANRS-Coquelicot study (2011–2013) conducted 1718 interviews with people over 18 who have injected or snorted a drug or medication (whether or not it was prescribed) at least once in their lifetime, who speak French or Russian, and who attend harm reduction facilities and drug treatment centers in France. Through stratified multivariate analyses based on gender using a Poisson regression, we determined risk factors. Results Among PWUD, 39.9% had attempted suicide (n = 655), with a distribution of 58.8% (n = 188) for women and 35.0% (n = 467) for men. Experiences of overdose, depression, receiving psychiatric care, setting during adolescence, daily alcohol use, and number of substances consumed during the last month were risk factors for men. Among women, experiences of overdose, self-reported HIV positive, and daily use of benzodiazepines and cocaine were risk factors. Conclusion we should develop psychiatric care into health services catering specifically to PWUD. As risk factors differed based on gender, we should strive to create distinct preventive health measures adapted to different populations. Keywords: people who use drugs; lifetime suicide attempts; gender; mental health, quantitative survey

Gender differences in risk factors and characteristics of young patients hospitalized for first acute coronary syndrome

Objective: To analyze the characteristics of modifiable risk factors, coronary artery lesions, reperfusion and drug treatment in young women hospitalized for first acute coronary syndrome (ACS). Methods: Clinical data of young adults of 18 to 44 years hospitalized for first ACS in Beijing Anzhen Hospital between January 2007 and December 2017 were analyzed. A total of 7 106 young adults with ACS were enrolled, 6 593(92.8%) were male and 513(7.2%) were female. There were 2 254(31.7%) patients with ST-segment elevation myocardial infarction (STEMI), 704(9.9%) patients with non-ST-segment elevation myocardial infarction (NSTEMI) and 4 148(58.4%) patients with unstable angina (UA). Clinical characteristics, laboratory examinations, coronary angiography and medical treatment were recorded. The gender differences in the characteristics of modifiable risk factors and coronary artery stenosis in young patients with ACS were also analyzed. Results: Dyslipidemia (87.5%) followed by overweight/obese(83.8%) and smoking (68.5%) were most prevalent modifiable risk factors in men. Dyslipidemia (63.4%), overweight/obese (63.4%) and hypertension (45.5%) were most prevalent modifiable risk factors in women. The prevalence rates of at least 1 risk factor in men and women patients were 99.1% and 87.9%, respectively. Between 2007 and 2017, the rates of hypertension and overweight/obese in men increased, and the rates of dyslipidemia and smoking decreased (trend P<0.01). The changes of incidence of modifiable risk factors through the years in women were not statistically significant. The rate of men receiving coronary angiography was higher than that in women (96.6% vs 93.4%, P<0.01). Women were more likely to suffer left main coronary artery disease than men (7.3% vs 4.1%, P<0.01). Multi-vessel coronary artery disease occurred more in men (43.4%), and single vessel coronary artery disease occurred more in women (47.0%). Women presented with STEMI had a lower probability of receiving clopidogrel/ticagrelor (76.8% vs 86.1%, P<0.01) and angiotensin Ⅰ-converting enzyme inhibitor/angiotonin receptor blocker (ACEI/ARB) (46.5% vs 60.2%, P<0.01) than that in men. Women presented with UA had a lower probability of receiving aspirin (86.3% vs 89.9%), clopidogrel/ticagrelor (69.7% vs 75.6%), statin (78.8% vs 85.0%) and ACEI/ARB (32.7% vs 38.6%) than men (all P<0.01). Women had a higher probability of presenting Killip II-IV than men (38.6% vs 25.6%, P<0.05). Conclusion: The majority of young patients with ACS were men. The prevalence rates of modifiable risk factors are very high in both man and woman. Compared with man, women with AMI are more likely to develop acute heart failure with lower probability of reperfusion and drug treatment.

Prevalence of Sexual Dysfunction and Related Risk Factors in Men with Multiple Sclerosis in Iran: A Multicenter Study

IntroductionSexual dysfunction (SD) is a common complaint in patients with multiple sclerosis (MS). The aim of this study was to assess the prevalence of SD and its related risk factors in men with MS in Iran.MethodsIn this cross-sectional study, 320 men who had been diagnosed with MS according to the McDonald revised criteria were recruited from January to June 2019, from the north, south, east, west, and central parts of Iran. Patients were assessed using the Male Sexual Health Questionnaire (MSHQ), International Index of Erectile Function (IIEF), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-(MSISQ 19), Sexual Quality of Life-Men (SQOL-M), and Standard General Health Questionnaire (GHQ).ResultsSexual dysfunction, defined as total IIEF score ≤ 45 was present in 114 patients (35.6%). The results of univariate logistic regression showed that there were significant direct relations between age (OR 1.050, 95% CI 1.02–1.08), Expanded Disability Status Scale (EDSS) (OR 1.45, 95% CI 1.24–1.7), duration of MS (OR 1.005, 95% CI 1.002–1.009), MSISQ-19 (OR 1.103, 95% CI 1.078–1.128), GHQ (OR 1.04, 95% CI 1.03–1.06), SQOL-M (OR 0.930, 95% CI 0.914–0.947), smoking (OR 1.941, 95% CI 1.181–3.188), non-MS chronic disease (OR 1.91, 95% CI 1.20–3.04), having a main sexual partner (OR 2.56, 95% CI 1.32–4.94), and significant inverse relations between exercise (OR 0.584, 95% CI 0.364–0.936) and regular sexual activity (OR 0.241, 95% CI 0.15–0.40), with the prevalence of SD. The results of multiple logistic regression indicated that the age, MSISQ-19, and SQOL-M were the only independent predictive factors for SD in these patients.ConclusionThe prevalence of SD in men with MS in Iran is relatively high. These patients should be screened, diagnosed, and treated for SD and influencing factors.

К ВОПРОСУ ОБ ОСОБЕННОСТЯХ СТРУКТУРЫ ФАКТОРОВ КАРДИОВАСКУЛЯРНОГО РИСКА У МУЖЧИН МОЛОЖЕ 60 ЛЕТ С ИНФАРКТОМ МИОКАРДА И ОСТРЫМ ПОВРЕЖДЕНИЕМ ПОЧЕК

Relevance. Acute kidney injury (AKI) worsens the prognosis of myocardial infarction (MI). Aim. To study the characteristics of cardiovascular (CVD) risk factors in men under 60 years of age with AKI in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with ACI - 25 patients; II - control, without it - 168 patients. A comparative analysis of the frequency of observation of the main and additional CVD risk factors in groups was performed. Results. In the patients of the study group, more often than in the control group, the following was observed: MI in winter (68.0 and 36.3%, respectively; p = 0.01), with repeated cases - the interval between infarction of more than one year (48.0 and 29.8%; p = 0.04); psychoemotional stress (64.0 and 46.1%; p = 0.04) or hypertensive crisis as a situation provoking MI (28.0 and 19.2%; p = 0.04); a history of: overweight less than 10 years (72.0 and 35.7%; p = 0.002) with moderate obesity (48.0 and 22.6%; p = 0.03), chronic heart failure (36.0 and 14.0%; p = 0.006), peptic ulcer (32.0 and 13.7%; p = 0.01), unstable angina (64.0 and 42.6%; p = 0.003), peripheral angiopathies (80.0 and 56.5%; p = 0.02), coronary angiography (45.5 and 25.5%; p = 0.04) and coronary artery bypass surgery (24.0 and 8.6%; p = 0.009). Conclusions. The structure of CVD risk factors in men under 60 years old with MI and AKI is characterized by the prevalence of moderate obesity, gastroduodenal ulcers, chronic heart failure, stress and crisis course of hypertension, coronary angiography and a history of coronary artery bypass surgery, as well as MI in winter. It is advisable to use the listed combinations of factors in predictive modeling and planning of preventive measures in such patients.

DCIS in Male and Aged Women with Comorbidities.

The incidence rates of ductal carcinoma in situ (DCIS) have increased rapidly over the last two decades in all patient groups including older women and men. DCIS in aged women has an excellent prognosis and the risk of local recurrence is lower compared to younger patients. Since adjuvant radiation after lumpectomy and endocrine treatment do not significantly influence overall survival a de-escalation of treatment especially in case of grade 1 lesions in women with comorbidities can be considered. Pure DCIS in men is a very rare disease representing approximately 5% of all male breast cancers. The most common type of DCIS in men is a papillary carcinoma mostly of low or intermediate grade developing from large central ducts, since male breast typically lacks lobules and terminal duct-lobular units (TDLU). A male DCIS of high grade is rare and mostly associated with severe hyperestrogenism, e.g., in case of gynecomastia. The most common risk factors in men are increasing age, high estrogen levels and positive family history. DCIS in men is usually a clinically apparent disease. The most common symptoms described in the literature are palpable, often cystic mass, coexisting or isolated nipple discharge (mostly bloody, in rare cases watery) or nipple alteration. A standard treatment among men with DCIS is a simple mastectomy without radiation. The prognosis is excellent.

Serum levels of klotho protein in men with arterial hypertension and its association with cardiometabolic risk factors

Aim. To study serum levels of Klotho protein in men with arterial hypertension and to explore its association with some cardiometabolic risk factors. Methods . 134 men with hypertension aged 50-65 years old and over 80 years old were enrolled in a study. 44 men of the corresponding age without high blood pressure were enrolled in the control group. Serum levels of Klotho protein were measured using ELISA. Results. Both, the study and the control group, have similar serum levels of Klotho protein (464 [287; 849] and 458 [128; 1121] pg/dL, respectively; p&gt;0.05). Significant differences in the serum levels of Klotho protein in the study groups are related to three risk factors: physical inactivity, obesity, and the presence of diabetes mellitus. A positive correlation between Klotho protein levels and regular physical activity has been found in men with arterial hypertension. Besides, negative correlations between Klotho proteins and diabetes mellitus and obesity have been stated. Multivariate analysis reports a positive association between Klotho protein and regular physical activity in men with hypertension regardless of their age, diabetes, lipid disorders, and obesity. Conclusion . Men with arterial hypertension and without it have similar Klotho protein levels. Serum Klotho protein levels are lower in obese men who are physically inactive. Klotho protein levels are lower in men with hypertension and concomitant diabetes mellitus. Klotho protein is positively associated with regular physical activity regardless of age and some cardiometabolic risk factors in men with arterial hypertension.

Testosterone Therapy and Cardiovascular Risk: A Critical Analysis of Studies Reporting Increased Risk

BackgroundTreatment of “adult-onset hypogonadism” (AOH) with exogenous testosterone therapy (TTh) to raise serum testosterone (T) levels may influence cardiovascular (CV) risk factors in patients with AOH, whereas low endogenous T levels are associated with an increased CV risk and mortality. AimTo critically evaluate studies reporting increased CV risk associated with TTh and to provide an overview of the risks and benefits of restoring T levels through exogenous TTh. MethodsA review of publications focusing on the association between TTh and increased CV risk was conducted, and the study methodologies and conclusions of each were critically evaluated. Further, recent clinical and epidemiological studies associating AOH or TTh with a change in CV risk, and pertinent hematologic and vascular effects noted in animal studies and in vitro, as well as in clinical practice were also reviewed. OutcomesA review of the literature shows that untreated testosterone deficiency and/or low T is associated with an increase in CV risk and adverse outcomes, with numerous studies and meta-analyses to support a positive association between exogenous TTh and an improvement in CV risk factors in men with AOH. ResultsNumerous studies in the literature demonstrate the positive benefits of using TTh; however, since 2013, some publications have suggested a link to increased CV risk associated with TTh. A number of these studies retrospectively analyzed insurance claims databases using diagnosis codes, procedures codes, and prescription information. Many reviews published since have pointed out the methodological flaws and debatable conclusions of these studies. Clinical ImplicationsA careful assessment of the patient's current health status and CV risk factors should be weighed against the benefits and possible risks resulting from TTh, and consideration should be given to deferring treatment pending resolution or stabilization of CV disease or risk factors. Strengths & LimitationsIn this review, we provide an in-depth analysis of studies reporting increased CV risk with TTh. Many of the studies were not well-designed, randomized, double-blind, prospective clinical trials but rather post hoc analyses of cohort data. These studies may reflect bias in how treatment and nontreatment decisions are made or reflect conclusions based on widely cited methodological flaws. ConclusionAppropriate patient selection supported by low pre-treatment T levels and monitoring T levels during treatment with the goal of achieving and maintaining physiologic levels all contribute to the safe and effective use of TTh in men with AOH.Khera M, Miner M, Jaffe J, et al. Testosterone Therapy and Cardiovascular Risk: A Critical Analysis of Studies Reporting Increased Risk. J Sex med 2021;18:83–98.

Psychosomatic medicine in the Gutenberg Health Study (GHS) - research questions, measurement instruments, selected results

Psychosomatic medicine in the Gutenberg Health Study (GHS) - research questions, measurement instruments, selected results Goal: Main questions from the Gutenberg Health Study (GHS) related to psychosomatic medicine are presented: (1) Prevalence and incidence of mental illnesses, (2) Sex-specific risk- and protective factors for mental health, (3) Interplay between psychological and somatic diseases and (4) methodical-psychometric developments. Methods: The GHS is an ongoing, prospective and interdisciplinary cohort study in Mainz. The comprehensive examinations include psychological characteristics and clinical and laboratory tests. 15010 respondents were selected in the baseline study from 2007 until 2012 and re-examined after 2.5 years and 5 years. Results: Of the first 5000 respondents in the baseline study 413 women (8.7 %) and 276 men (5.8 %) indicated depressive symptoms (PHQ-9 > = 10). After five years, half of the participants with depressive symptoms at baseline also indicated depressive symptoms five years later. Risk factors for men were a lack of social support, for women smoking and Type D personality. The proportion of new cases of depression at follow-up was 4.4 %. Risk factors were symptoms of anxiety, Type D, smoking and comorbid cancer. Protective were age and social support. Findings on the association of physical and mental disorders and their behavioral and biological links (atherosclerosis, inflammation) are presented. Conclusions: Prospective assessment of biological, psychological and social parameters offers the possibility to study their interplay in the development of mental and somatic illnesses.

Abstract 13902: Gender Differences in Lipoprotein Parameters in Cardiovascular Disease Risk; The Framingham Offspring Study

Introduction: Elevated serum lipoprotein cholesterol levels have been considered as atherosclerosis cardiovascular disease (ASCVD) risk factors. However, gender differences among these lipoproteins have not become clear. Hypothesis: Our hypothesis was that gender differences exist with regard to serum lipoprotein cholesterol levels and the risk of ASCVD risk in the prospective Framingham Offspring Study. Methods: A total of 1300 men and 1676 women, none of whom had ASCVD at baseline, were followed for a median time of 16 years for new onset fatal or non fatal myocardial infarction or stroke, coronary angioplasty or bypass, or carotid or peripheral vascular surgery (302 of 1300 or 23.2% of men and 226 of 1676 or 13.5% of women developed). At baseline, standard risk factors including fasting total and high density lipoprotein (HDL) cholesterol, and triglycerides were assessed, as were direct, small dense, and large low density lipoprotein (LDL) cholesterol and LDL triglyceride (LDL-TG), remnant lipoprotein cholesterol and lipoprotein(a) were measured. Univariate and multivariate analyses were carried out to assess relationships to disease risk. Results: All parameters were associated with ASCVD risk on univariate analysis. On multivariate analysis after controlling for all standard risk factors (age, hypertension, use of anti-hypertensive medication, diabetes, smoking, total cholesterol, HDL cholesterol, and use of cholesterol lowering medication), only lipoprotein(a) was significant in men with a 1.26 hazard ratio (P = 0.009), while small dense LDL cholesterol and LDL-TG, but not lipoprotein(a), were significant risk factors in women (hazard ratios 1.65 and 1.35, P = 0.007 and 0.015, respectively). Using the pooled cohort equation, only lipoprotein(a) added significant risk information in men and only small dense LDL cholesterol and LDL-TG added significant risk information in women. Conclusions: Our data indicate that men are at significantly higher disease risk then women, and that elevated lipoprotein(a) is a significant independent ASCVD risk factor in men, while small dense LDL cholesterol and LDL-TG are significant independent ASCVD risk factors in women after controlling for all other standard cardiovascular disease risk factors.

Incidence of Nongonococcal Urethritis in Men Who Have Sex With Women and Associated Risk Factors.

Incidence and risk factors for nongonococcal urethritis (NGU) remain poorly defined. We conducted a cohort study to estimate the incidence of NGU and identify risk factors in men who have sex with women. We enrolled cisgender male sexually transmitted disease clinic attendees 16 years or older who reported exclusively female partners. At enrollment and 6 monthly follow-up visits, men underwent a clinical examination, provided urethral swab and urine specimens, completed a sexual behavior survey and biweekly diaries, and were tested for Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) using Aptima assays (Hologic, Inc). Nongonococcal urethritis was defined as ≥5 polymorphonuclear leukocytes per high-power field plus either urethral symptoms or visible discharge. We estimated the incidence of NGU overall, asymptomatic and symptomatic NGU, non-CT/non-MG NGU, and CT/MG-associated NGU using Poisson regression for clustered outcomes. We performed relative risk binomial regression for clustered data to identify characteristics associated with incident NGU. From August 2014 to July 2018, 307 participants at risk for NGU contributed 109.4 person-years. Median age was 32 years, and 52% were White. At enrollment, 107 men had NGU; of these, 88% were symptomatic, 27% had CT, and 22% had MG. Fifty men had 60 cases of incident NGU (incidence rate, 56 per 100 person-years; 95% confidence interval, 43-74). Unlike prevalent NGU at enrollment, CT/MG-associated incident NGU was rare (incidence rate, 7; 95% confidence interval [CI], 4-15), and most (78%) incident NGU was asymptomatic. Risk factors for incident NGU were ≤ high school education (adjusted rate ratio [ARR], 2.45; 95% CI, 1.19-5.00), history of CT (ARR, 2.15; 95% CI, 1.08-4.27), history of NGU (ARR, 2.67; 95% CI, 1.27-5.62), and NGU at enrollment (ARR, 2.03; 95% CI, 1.04-3.98). Neither condom use nor having a new partner was associated with incident NGU; Black race was only associated with incident symptomatic and non-CT/non-MG NGU. Incidence of NGU was high, predominantly non-CT/non-MG and asymptomatic. Future studies should investigate the etiology and clinical significance of asymptomatic NGU.

CONTEMPORARY RISK FACTORS FOR CARDIOVASCULAR OUTCOMES AMONG MEN AND WOMEN - INSIGHTS FROM THE CARTAGENE STUDY

Since the seminal Framingham report, several predictors of adverse cardiovascular (CV) outcomes have been identified. However, it remains unclear whether these risk factors have differential effects among men and women. We aimed to evaluate the impacts of established and potential risk factors in men and The CARTaGENe study was a prospective cohort study with a random sampling of individuals (40-70 years) in Québec, Canada. Participants were enrolled in 2009 and followed until 2016. For this analysis, we retained only subjects without prior cardiovascular (CV) events (CVE) or CV interventions (CVI).

Male-to-Female Presumed Transmission of Toxoplasmosis Between Sexual Partners.

Toxoplasmosis is one of the most widespread human parasitoses in developed countries. Sexual transmission has been confirmed in several animal species, and indirect evidence suggests it may occur in humans. We compared the seropositivity to Toxoplasma gondii in couples who visited the Center for Assisted Reproduction in Prague from June 2016 to June 2018 and analyzed various risk factors including the serological status of sexual partner. By comparing the risk factors in men and women, we tested the hypothesis of male-to-female sexual transmission of toxoplasmosis. The prevalence of toxoplasmosis in women with infected male partners (25.6%; n=156) was higher than in women with uninfected male partners (18.2%; n=477; P=0.045). Therefore, a partner's seropositivity seems to be a risk factor for infection in women (n=593; prevalence ratio=1.418; P=0.045) but not in men (n=573; prevalence ratio=1.058; P=0.816). Our results support the hypothesis of the sexual transmission of T. gondii from men to women. The risk may seem relatively low, but transmission can occur during unprotected sexual intercourse, which may be at the time of conception. Because of the risk of congenital toxoplasmosis, a lower risk of infection than that observed in our study can represent a serious health problem.

Sex differences in prevalence, treatment and control of cardiovascular risk factors in England

ObjectiveTo investigate sex differences in prevalence, treatment and control of major cardiovascular risk factors in England.MethodsData from the Health Survey for England 2012–2017 on non-institutionalised English adults (aged ≥16 years)...