Sex-Specific Differences in Lipoprotein Production and Clearance

Abstract

Therapeutic approaches to reduce atherogenic lipid and lipoprotein levels remain the most effective and assessable strategies to prevent and treat cardiovascular disease. The discovery of novel research targets linked to pathways associated with cardiovascular disease development has enhanced our ability to decrease disease burden; however, residual cardiovascular disease risks remain. Advancements in genetics and personalized medicine are essential to understand some of the factors driving residual risk. Biological sex is among the most relevant factors affecting plasma lipid and lipoprotein profiles, playing a pivotal role in the development of cardiovascular disease. This minireview summarizes the most recent preclinical and clinical studies covering the effect of sex on plasma lipid and lipoprotein levels. We highlight the recent advances in the mechanisms regulating hepatic lipoprotein production and clearance as potential drivers of disease presentation. We focus on using sex as a biological variable in studying circulating lipid and lipoprotein levels.

Effect of Adding Apolipoprotein B Testing on the Prevalence of Dyslipidemia and Risk of Cardiovascular Disease in the Korean Adult Population

“…However, ApoB levels and the prevalence of high ApoB did not significantly differ between sexes in this study. There have been inconsistent findings regarding ApoB levels by sex in the literature [ 18 , 32 , 33 ]. Serum lipid levels can be influenced by genetic background, hormonal changes, lifestyle factors, and healthcare behaviors, including access to healthcare facilities and adherence to physicians’ recommendations [ 2 , 32 , 33 ].…”

“…There have been inconsistent findings regarding ApoB levels by sex in the literature [ 18 , 32 , 33 ]. Serum lipid levels can be influenced by genetic background, hormonal changes, lifestyle factors, and healthcare behaviors, including access to healthcare facilities and adherence to physicians’ recommendations [ 2 , 32 , 33 ]. However, limited data exist on the ApoB test in the Korean population to determine which factors are associated with ApoB levels.…”

Finasteride delays atherosclerosis progression in mice and is associated with a reduction in plasma cholesterol in men

“…Sex hormones have a profound impact on gene expression in tissues including the liver, where they regulate inflammation and lipid metabolism (recently reviewed in ( 94 , 95 )). Finasteride treatment resulted in a shift in circulating sex hormones and hepatic sex hormones toward estrogen excess, as reported in the past ( 18 , 50 , 61 , 72 ).…”

Directly Measuring Atherogenic Lipoprotein Kinetics in Zebrafish with the Photoconvertible LipoTimer Reporter

“…Static measures of LDL-cholesterol have been successfully used in clinical settings to evaluate patient CVD risk (25), however, the kinetics of B-lps likely play a major role in CVD disease pathology (26,27). and due to the difficulties in performing these assays, they are only quantified in a subset of studies.…”