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Gender differences in the metabolic syndrome and their role for cardiovascular disease

An Erratum to this article was published on 30 January 2006

Summary

Women live longer than men and develop cardiovascular disease (CVD) at an older age. The metabolic syndrome represents a major risk factor for the development of CVD, and gender1 differences in this syndrome may contribute to gender differences in CVD.

In recent years, the metabolic syndrome has been more prevalent in men than in women. Prevalence is increasing and this increase has been steeper in women, particularly in young women, during the last decade. The contributions of the different components of the metabolic syndrome differ between genders and in different countries.

In a recent survey in Germany, 40% of the adult population had been diagnosed with disturbed glucose tolerance or type 2 diabetes. Undiagnosed diabetes was more frequent in men than in women, and risk factors for undiagnosed diabetes differed between the sexes. Worldwide, in individuals with impaired glucose tolerance, impaired fasting glucose was observed more frequently in men, whereas impaired glucose tolerance occurred relatively more often in women. Lipid accumulation patterns differ between women and men. Premenopausal women more frequently develop peripheral obesity with subcutaneous fat accumulation, whereas men and postmenopausal women are more prone to central or android obesity. In particular, android obesity is associated with increased cardiovascular mortality and the development of type 2 diabetes. Visceral adipocytes differ from peripheral adipocytes in their lipolytic activity and their response to insulin, adrenergic and angiotensin stimulation and sex hormones. Visceral fat is a major source of circulating free fatty acids and cytokines, which are directly delivered via the portal vein to the liver inducing insulin resistance and an atherogenic lipid profile. Inflammation increases cardiovascular risk particularly in women. A relatively greater increase in cardiovascular risk by the appearance of diabetes in women has been reported in many studies.

Thus, the presently available data suggest that the pathophysiology of the metabolic syndrome and its contribution to the relative risk of cardiovascular events and heart failure show gender differences, which might be of potential relevance for prevention, diagnostics, and therapy of the syndrome.

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Correspondence to Vera Regitz-Zagrosek.

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1 "Gender" is used to include biological sex as well as gender in its strict sense

Supported by the DFG (grants to V. Regitz–Zagrosek) and the BMBF (Competence Network Heart Failure)

An erratum to this article can be found at http://dx.doi.org/10.1007/s00392-006-0377-8

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Regitz-Zagrosek, V., Lehmkuhl, E. & Weickert, M.O. Gender differences in the metabolic syndrome and their role for cardiovascular disease. Clin Res Cardiol 95, 136–147 (2006). https://doi.org/10.1007/s00392-006-0351-5

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Key words

  • Metabolic syndrome
  • cardiovascular disease
  • gender differences