scholarly journals Gender Differences in Diabetic Kidney Disease: Focus on Hormonal, Genetic and Clinical Factors

2021 ◽  
Vol 22 (11) ◽  
pp. 5808
Author(s):  
Annalisa Giandalia ◽  
Alfio Edoardo Giuffrida ◽  
Guido Gembillo ◽  
Domenico Cucinotta ◽  
Giovanni Squadrito ◽  
...  
Keyword(s):  
Gender Differences ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Sex And Gender ◽  
Clinical Factors ◽  
Diabetic Kidney ◽  
And Gender ◽  
The Impact

Diabetic kidney disease (DKD) is one of the most serious complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Current guidelines recommend a personalized approach in order to reduce the burden of DM and its complications. Recognizing sex and gender- differences in medicine is considered one of the first steps toward personalized medicine, but the gender issue in DM has been scarcely explored so far. Gender differences have been reported in the incidence and the prevalence of DKD, in its phenotypes and clinical manifestations, as well as in several risk factors, with a different impact in the two genders. Hormonal factors, especially estrogen loss, play a significant role in explaining these differences. Additionally, the impact of sex chromosomes as well as the influence of gene–sex interactions with several susceptibility genes for DKD have been investigated. In spite of the increasing evidence that sex and gender should be included in the evaluation of DKD, several open issues remain uncovered, including the potentially different effects of newly recommended drugs, such as SGLT2i and GLP1Ras. This narrative review explored current evidence on sex/gender differences in DKD, taking into account hormonal, genetic and clinical factors.

scholarly journals Decision Algorithm for Prescribing SGLT2 Inhibitors and GLP-1 Receptor Agonists for Diabetic Kidney Disease

2020 ◽  
Vol 15 (11) ◽  
pp. 1678-1688 ◽  
Author(s):  
Jiahua Li ◽  
Oltjon Albajrami ◽  
Min Zhuo ◽  
Chelsea E. Hawley ◽  
Julie M. Paik
Keyword(s):  
Kidney Disease ◽  
Kidney Failure ◽  
Diabetic Kidney Disease ◽  
Diabetes Management ◽  
Mitigation Strategies ◽  
Current Evidence ◽  
Atherosclerotic Cardiovascular Disease ◽  
Decision Algorithm ◽  
Diabetic Kidney ◽  
Kidney Protection

Diabetic kidney disease and its comorbid conditions, including atherosclerotic cardiovascular disease, heart failure, diabetes, and obesity, are interconnected conditions that compound the risk of kidney failure and cardiovascular mortality, and exponentiate health care costs. Sodium glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide 1 receptor agonist (GLP-1 RA) are novel diabetes medications that prevent cardiovascular events and kidney failure. Clinical trials exploring the cardiovascular and kidney outcomes of SGLT2i and GLP-1 RA have fundamentally shifted the treatment paradigm of diabetes. Clinical guidelines for diabetes management recommend a more holistic approach beyond glycemic control and emphasize heart and kidney protection of SGLT2i and GLP-1 RA. However, the adoption of prescribing SGLT2i and GLP-1 RA for patients with diabetes and high cardiovascular and kidney risk has been slow. In this review, we provide a decision-making tool to help clinicians determine when to consider SGLT2i and GLP-1 RA for heart and kidney protection. First, we discuss a comprehensive risk assessment for patients with diabetic kidney disease. We compare the effectiveness of SGLT2i and GLP-1 RA for different risk categories. Then, we present a decision algorithm using cardiovascular and kidney failure risk stratification and the strength of current evidence for the use of SGLT2i and GLP-1 RA. Lastly, we review the adverse effects of SGLT2i and GLP-1 RA and propose mitigation strategies.

scholarly journals Collagen Deposition in Diabetic Kidney Disease Boosts Intercellular Signaling: A Mathematical Model

2021 ◽  
Author(s):  
Haryana Y. Thomas ◽  
Ashlee N. Ford Versypt
Keyword(s):  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Cellular Function ◽  
Collagen Deposition ◽  
Intercellular Signaling ◽  
Diabetic Kidney ◽  
Kidney Glomerulus ◽  
The Us ◽  
Matrix Properties ◽  
The Impact

Diabetic kidney disease is a health burden that is becoming more prevalent in the US and worldwide. The limited options for treating and preventing diabetic kidney disease are in part due to gaps in our understanding of the progression of diabetic kidney damage and its impacts on cellular function. An important cellular function in the kidney glomerulus is intercellular communication via the release and uptake of soluble cytokines and growth factors. In diabetic kidney disease, excess collagen deposition alters the mesangial matrix properties, which, we hypothesize, diminishes the intercellular signaling between key glomerular cells. To test our hypothesis, we utilized established mathematical models of transport to study the impact of pathological deposition on the ability of cells to communicate via intercellular signaling. Our analysis reveals that pathological collagen deposition can enhance the signaling range of the glomerular cells rather than diminishing it.

scholarly journals Gender-specific aspects of epidemiology, molecular genetics and outcome: lung cancer

ESMO Open ◽  
2020 ◽  
Vol 5 (Suppl 4) ◽  
pp. e000796
Author(s):  
Nuria Mederos ◽  
Alex Friedlaender ◽  
Solange Peters ◽  
Alfredo Addeo
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Lung Cancer ◽  
Gender Differences ◽  
Sex And Gender ◽  
Never Smokers ◽  
And Gender ◽  
The Impact ◽  
Gender Specific ◽  
Sex And Gender Differences

Lung cancer remains the leading cause of cancer-related deaths worldwide in women and men. In incidence, lung cancer ranks second, surpassed by breast cancer in women and prostate cancer in men. However, the historical differences in mortality and incidence rate between both sexes have changed in the last years. In the last decades, we have also witnessed an increased number of lung cancer in female never-smokers. These disparities have grown our interest in studying the impact of the gender and sex in the presentation of lung cancer. The aetiology is yet to be fully elucidated, but the data are clear so far: there is a growing divide between lung cancer presentation in women and men that will change our management and study of lung cancer. This article aims to review the sex and gender differences in lung cancer.

scholarly journals POS-628 THE IMPACT OF OBESITY ON ADVERSE OUTCOME OF COVID-19 IN PATIENTS ON MAINTENANCE HEMODIALYSIS DUE TO DIABETIC KIDNEY DISEASE

2021 ◽  
Vol 6 (4) ◽  
pp. S274
Author(s):  
E. Zeltyn-Abramov M. ◽  
N. Belavina I. ◽  
N. Frolova F. ◽  
N. Poteshkina G. ◽  
N. Klochkova N. ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Adverse Outcome ◽  
Maintenance Hemodialysis ◽  
Diabetic Kidney ◽  
The Impact

scholarly journals New Insights into the Mechanisms of Pyroptosis and Implications for Diabetic Kidney Disease

2020 ◽  
Vol 21 (19) ◽  
pp. 7057
Author(s):  
Jinwen Lin ◽  
Ao Cheng ◽  
Kai Cheng ◽  
Qingwei Deng ◽  
Shouzan Zhang ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renal Cell ◽  
Diabetic Kidney Disease ◽  
Microvascular Complications ◽  
Canonical Pathway ◽  
Cell Swelling ◽  
Current Evidence ◽  
Glomerular Sclerosis ◽  
Diabetic Kidney

Pyroptosis is one special type of lytic programmed cell death, featured in cell swelling, rupture, secretion of cell contents and remarkable proinflammation effect. In the process of pyroptosis, danger signalling and cellular events are detected by inflammasome, activating caspases and cleaving Gasdermin D (GSDMD), along with the secretion of IL-18 and IL-1β. Pyroptosis can be divided into canonical pathway and non-canonical pathway, and NLRP3 inflammasome is the most important initiator. Diabetic kidney disease (DKD) is one of the most serious microvascular complications in diabetes. Current evidence reported the stimulatory role of hyperglycaemia-induced cellular stress in renal cell pyroptosis, and different signalling pathways have been shown to regulate pyroptosis initiation. Additionally, the inflammation and cellular injury caused by pyroptosis are tightly implicated in DKD progression, aggravating renal fibrosis, glomerular sclerosis and tubular injury. Some registered hypoglycaemia agents exert suppressive activity in pyroptosis regulation pathway. Latest studies also reported some potential approaches to target the pyroptosis pathway, which effectively inhibits renal cell pyroptosis and alleviates DKD in in vivo or in vitro models. Therefore, comprehensively compiling the information associated with pyroptosis regulation in DKD is the main aim of this review, and we try to provide new insights for researchers to dig out more potential therapies of DKD.

scholarly journals Sex-Related Factors in Cardiovascular Complications Associated to COVID-19

Biomolecules ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 21
Author(s):  
Francesca Megiorni ◽  
Paola Pontecorvi ◽  
Giulia Gerini ◽  
Eleni Anastasiadou ◽  
Cinzia Marchese ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Cardiovascular Complications ◽  
Sex And Gender ◽  
Biological Factors ◽  
Related Factors ◽  
Gender Influence ◽  
Behavioral Cues ◽  
And Gender ◽  
The Impact ◽  
Symptoms And Signs

Coronavirus disease 2019 (COVID-19), the pandemic infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with an extremely heterogeneous spectrum of symptoms and signs. The clinical manifestations seem to be correlated with disease severity. COVID-19 susceptibility and mortality show a significant sex imbalance, with men being more prone to infection and showing a higher rate of hospitalization and mortality compared to women. Such variability can be ascribed to both sex-related biological factors and gender-related behavioral cues. This review will discuss the potential mechanisms accounting for sex/gender influence in vulnerability to COVID-19. Cardiovascular diseases play a central role in determining COVID-19 outcome, whether they are pre-existent or arose upon infection. We will pay particular attention to the impact of sex and gender on cardiovascular manifestations related to COVID-19. Finally, we will discuss the sex-dependent variability in some biomarkers for the evaluation of COVID-19 infection and prognosis. The aim of this work is to highlight the significance of gendered medicine in setting up personalized programs for COVID-19 prevention, clinical evaluation and treatment.

Sign in / Sign up

Export Citation Format

Share Document