Sex affects health: women are different than men

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Sex affects health women are different than men

1. Osteoporosis
2. Different patterns of Melanoma occurrence
3. Autoimmune conditions
4. Body composition metabolism

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Sex affects health

• Males females have different patterns of
  illness
• Diseases other than those of the reproductive
  system affect both sexes, often with different
  frequencies or presentations or they may
  require different treatments

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I. Osteoporosis

• Osteoporosis
• Results when the rate of bone resorption
  outstrips the rate of bone formation
• 35 of all women gt65 years old have osteoporosis
  (15 of all Caucasian women)

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Normal bone T-score better than -1.
Osteopenia T-score between -1 and -2.5
Osteoporosis T-score less than -2.5
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Factors that contribute to bone health

• Dietary Calcium Vitamin D required for bone
  formation
• Premenopausal women should obtain 1,000 mg/day
• Postmenopausal women 1,200 to 1,500 mg/day
• Estrogen testosterone critical for maintenance
  of peak bone mass
• Weight bearing exercise creates strong bone
  structure
• Smoking weakens the bone structure
• Certain drugs ( e.g. Corticosteroids) promote
  bone loss

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II. Different patterns of Melanoma occurrence

• non-melanoma
• Melanoma
• Incidence higher among women, however mortality
  higher among men
• Cause
• Risk factors

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Early detection is critical!!!
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III. Autoimmune conditions

• The adaptive immune response
• Activation of the complement and coagulation
  systems
• plasma activity level of phospholipase A2, a key
  enzyme in causing chronic inflammatory diseases,
  is significantly higher in Caucasian women than
  their male counterparts
• Interleukin-1-receptor-II (reduces the
  inflammatory response), is present in higher
  concentration in men than women

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A. Autoimmune disease

• May be localized or ubiquitous
• Difficult to identify leading causes, difficult
  to diagnose
• May be associated with infectious agents (virus,
  bacteria)
• Hypothesized that "molecular mimicry may be
  occurring- epitopes of the microorganism closely
  resemble self-antigens
• "bystander effect" microorganisms expose
  self-antigens to the immune system by directly
  damaging tissues during an active infection
• Many autoimmune disease are highly predominant in
  females, most during their child-bearing years
• Systemic and organ-specific autoimmune diseases,
  (e.g. rheumatoid arthritis, myocarditis) are the
  leading cause of death in women gt65 years of age

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Infections occur before the onset of symptoms of
autoimmune disease, making links to specific
causative agents difficult. When a person is
first infected (day 0), usually no symptoms are
apparent. Signs and symptoms of autoimmune
disease are clearly present and easily confirmed
by physicians during the chronic stage of
autoimmunity. However, the infection has been
cleared by this time, making it difficult to
establish that an infection caused the autoimmune
disease (from Fairweather Rose, 2004)
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Some common autoimmune diseases

• Hashimotos thyroiditis (underactive thyroid)
• Tiredness, depression
• sensitivity to cold, muscle weakness and cramps
• weight gain, dry hair, tough skin
• constipation
• Graves disease (overactive thyroid)
• Insomnia, irritability, weight loss, heat
  sensitivity, fine brittle hair
• weakness in your muscles, shaky hands
• Lupus
• swelling and damage to the joints, skin, kidneys,
  heart, lungs, blood vessels, and brain
• rashes on parts of the body
• Multiple sclerosis (MS)
• weakness and trouble with coordination, balance,
  speaking, and walking
• tremors
• numbness and tingling feeling in arms, legs,
  hands, and feet
• Rheumatoid arthritis
• inflammation of the joints
• muscle pain, weakness, fatigue

• Symptoms of autoimmune diseases can come and go,
  and severity can vary

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6.7 million women affected by autoimmune disease
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B. Why are these autoimmune diseases affecting
more females than males?

• Genetics?
• AD tend to cluster in families and in individuals
  which suggests that common mechanisms are
  involved in disease susceptibility
• However, twins studies indicate that genetic as
  well as environmental factors are necessary
• Hormones?
• Variety of sex hormone receptors found on immune
  cells cytokine receptors have likewise been
  discovered on hormone-producing tissues, which
  suggests bidirectional regulation of the immune
  response
• Proinflammatory cytokines stimulate the release
  of glucocorticoids from the hypothalamus-pituitary
  -adrenal axis, which regulates the inflammatory
  process, along with androgens and estrogen
• Recent study found that Estrogen amplifies the
  immune response to coxsackievirus B3 in mice,
  increasing TNF-a and IL-4 levels
• Different environmental exposure than men?

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IV. Body composition metabolism

• Body fat
• Hormonal changes may increase a females appetite
• Menopause is associated with a shift toward more
  fat deposition of fat in abdominal region
• Different energy requirements due to different
  body size, composition and activity levels