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Sex and Gender-Related Issues in the Era of Personalized Medicine

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Sex, Gender and Hormone Based Medicine".

Deadline for manuscript submissions: 22 May 2025 | Viewed by 9605

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Special Issue Editors

Dr. Davide Bizzoca

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Guest Editor

1. UOSD Spinal Surgery, AOU Policlinico di Bari, Bari, Italy
2. Department DiMePre-J, University of Bari "Aldo Moro", Bari, Italy
Interests: scoliosis; kyphosis; spine fractures; degenerative disk diseases; spinal surgery; spinal tumours; spine metastasis; osteoarthritis; tendinopathy; omic sciences; proteomics; metabolomics; PRP; PDRN; mesenchymal stem cells; gender-medicine; gender-related differences; MRI; biophysical stimulation; CCEFs; PEMFs; vertebral bone marrow edema; precision medicine; osteoporosis; osteosarcopenia

Dr. Anna Maria Moretti

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Guest Editor

President of International Society for Gender Medicine (IGM), President of Gruppo Italiano Salute e Genere (GISeG), Department of Pneumology, Santa Maria Hospital, Via De Ferrariis 18/D, 70124 Bari, Italy
Interests: pneumologia; lung diseases; gender-related differences; sex-related differences; gender indicators; precision medicine

Prof. Dr. Biagio Moretti

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Guest Editor

Orthopaedic and Trauma Unit, Department DiBraiN, University of Bari "Aldo Moro ", Bari, Italy
Interests: trauma; orthopedic surgery; arthroplasty; rehabilitation; tendon; physical activity; osteoarthritis; osteoporosis; fragility fractures; biophysical stimulation; gender-related differences; musculoskeletal diseases
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Special Issue Information

Dear Colleagues,

Gender medicine studies sex- and gender-based differences in the development and prevention of diseases, the awareness and presentation of symptoms, and the effectiveness of therapy. Gender medicine is a part of personalized medicine, considering differences in biological and psychosocial factors individually. There are differences in genes, chromosomes, hormones, and metabolism as well as differences in culture, environment, and society. There are prominent differences between men and women in medicine regarding the immune system, inflammation, and noncommunicable diseases such as obesity, type 2 diabetes, hypertension, and cardiovascular disease.

In this Special Issue, we will offer investigators and clinical practitioners operating in multiple fields of medicine and nursing care the opportunity to report and share their personal experience and research data from gender medicine and gender factors/differences in women and men. We welcome original studies and review papers.

Dr. Davide Bizzoca
Dr. Anna Maria Moretti
Prof. Dr. Biagio Moretti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

gender
sex differences
sex factors
personalized medicine
cardiovascular disease
hypertension
obesity
diabetes
psychiatry and psychology
public health and epidemiology
women’s health
sex
osteoporosis
osteoarthritis
musculoskeletal diseases

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Published Papers (7 papers)

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Research

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8 pages, 214 KiB

Open AccessArticle

The Impact of Frailty and Gender Differences on Hospitalization and Complications in Proximal Femoral Pathological Fractures: A Cross-Sectional Study

by Alessandro El Motassime, Elisa Pesare, Andrea Russo, Sara Salini, Giordana Gava, Carla Recupero, Tommaso Giani, Marcello Covino, Giulio Maccauro and Raffaele Vitiello

J. Pers. Med. 2024, 14(9), 991; https://doi.org/10.3390/jpm14090991 - 18 Sep 2024

Viewed by 817

Abstract

Background: Frailty associated with aging increases the risk of falls, disability, and death. The aim of this study is to explore gender-related disparities in the survival outcomes of pathological femoral fractures in older frail patients, while analyzing potential specific prognostic factors. Methods: This study is a retrospective observational analysis conducted at a single medical center. It enrolled all patients aged 65 and above who were admitted to our emergency department between 2016 and 2020 with a diagnosis of pathological femur fracture requiring surgical intervention. The primary study endpoint was evaluating gender-related differences in survival outcomes. The secondary endpoint involves investigating gender-specific prognostic factors through the analysis of clinical and laboratory parameters. Results: The average Charlson Comorbidity Index (CCI) was slightly lower in men, but the difference was not statistically significant (p = 0.53). The Clinical Frailty Scale (CFS) showed similar results, with men and women 5.23 (SD 1.46), also not significant (p = 0.83). An evaluation comparing patients aged 75 years or younger to those older than 75 years found significant differences in health metrics. The average CCI was higher in the over 75 group compared to the under 75 group, with a p-value of 0.001. Similarly, the CFS average was also greater in the over 75 group than in the under 75 group, with a p-value of 0.0001. Complications were more frequent in patients over 75 and those with lower educational qualifications. The evaluation analyzed cardiac patients compared to a control group, revealing that the average age of cardiac patients was 75.22 years, while the control group was younger at 73.98 years (p = 0.5119). The CCI for cardiac patients averaged 6.53, significantly higher than 4.43 for non-cardiac patients (p = 0.0003). Conclusion: Frailty assessment is therefore essential in patients with pathological fracture of the proximal femur and is an important predictor of both gender differences and hospital complications. Enhancing gender analysis in this field is crucial to gather more robust evidence and deeper comprehension of potential sex- and gender-based disparities. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

10 pages, 543 KiB

Open AccessArticle

Socioeconomic Gender Variables Impact the Association between Hypertension and Chronic Health Issues: Cross-Sectional Study

by Simon David Lindner, Teresa Gisinger, Peter Klimek and Alexandra Kautzky-Willer

J. Pers. Med. 2024, 14(8), 890; https://doi.org/10.3390/jpm14080890 - 22 Aug 2024

Viewed by 563

Abstract

Our aim is to investigate if sex and gender influence the association of hypertension and their comorbidities. We investigated how gender differences in five socioeconomic factors impact the relation between hypertension and ten comorbidities including diabetes mellitus, renal disease, and chronic pulmonary disease in European countries grouped by their gender inequality index using representative survey data from the European Health Interview Survey. Using logistic regressions, we compute the ratio of odds ratios in females versus males. Therefore, an ORR > 1 is associated with a higher odds ratio for females than for males while an ORR < 1 means the opposite. To account for multiple hypothesis testing, we applied the Bonferroni correction. Hypertension in both sexes was associated with lower educational level, being unemployed, and lower income. In males, being divorced/widowed (OR1.12, p < 0.001) had an association to hypertension, whereas in females, being common-law/married (OR1.30, p < 0.001) and being divorced/widowed (OR1.17, p < 0.001) was associated with a higher risk for hypertension. Moreover, in hypertension, females who worked had an association with myocardial infarction (OR1.39, p < 0.001) and having post-secondary education had an association with arthrosis (OR 1.35, p < 0.001) compared to males. Our findings show that gender variables influence the association of hypertension and comorbidities, especially in females. These results can be used to inform targeted prevention measures taking gender-specific contextual factors into account. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

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11 pages, 620 KiB

Open AccessArticle

Sex Differences in Albumin Quotient and Cerebrospinal Fluid Total Protein Content Do Not Depend on Anthropometric Factors

by Massimiliano Castellazzi, Raffaella Candeloro, Caterina Trevisan, Samantha Permunian, Gaia Buscemi, Sara Ghisellini, Giovanna Negri, Giada Gilli, Caterina Ferri, Tiziana Bellini, Stefano Pizzicotti and Maura Pugliatti

J. Pers. Med. 2024, 14(4), 362; https://doi.org/10.3390/jpm14040362 - 29 Mar 2024

Cited by 1 | Viewed by 1058

Abstract

(1) Background: Cerebrospinal fluid (CSF)/serum albumin quotient (QAlb) and CSF total protein (TP) are more elevated in males than females, and this has been hypothesised to be due to anthropometric differences between the sexes. This study aimed to investigate QAlb and CSF TP as a function of body height, weight, and body mass index (BMI). (2) Methods: A total of 207 patients were included in the study and analysed blinded to clinical diagnosis. (3) Results: Multivariable linear regressions were run to predict log-transformed Qalb and log-transformed CSF TP value from age, sex, weight, and height (first model) or from age, sex, and BMI (second model). In both models, age (β = 0.004, 95% CI = 0.002 to 0.006) and sex (β = −0.095, 95% CI = −0.169 to −0.021, and β = −0.135, 95% CI = −0.191 to −0.079) were significant predictors for QAlb, but weight, height, and BMI were not. Similarly, age (β = 0.004, 95% CI = 0.003 to 0.006) and sex (β = −0.077, 95% CI = −0.142 to −0.013, and β = −0.109, 95% CI = −0.157 to −0.060) were significant predictors for CSF TP, while anthropometric characteristics were not. No differences in QAlb and CSF TP were found when grouping males and females by BMI status. (4) Conclusions: Our data suggest that anthropometric characteristics could not explain the sex-related differences in QAlb and CSF TP. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

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11 pages, 1203 KiB

Open AccessArticle

Exploring Pelvic Symptom Dynamics in Relation to the Menstrual Cycle: Implications for Clinical Assessment and Management

by Maria Blanco-Diaz, Ana Vielva-Gomez, Marina Legasa-Susperregui, Borja Perez-Dominguez, Esther M. Medrano-Sánchez and Esther Diaz-Mohedo

J. Pers. Med. 2024, 14(3), 239; https://doi.org/10.3390/jpm14030239 - 23 Feb 2024

Viewed by 1275

Abstract

Background: Pelvic floor dysfunctions (PFDs) encompass an array of conditions with discrepant classification systems, hampering accurate prevalence estimation. Despite potentially affecting up to 25% of women during their lifetime, many remain undiagnosed, underestimating the true extent. Objectives: This cross-sectional study aimed to examine the impacts of the menstrual cycle on PFDs and dysfunctions. Secondary objectives included investigating differences between athletic and nonathletic women. Methods: An online questionnaire examined the effects of the menstrual cycle (MC) on 477 women’s pelvic symptoms (aged 16–63 years), stratified by athletic status. This ad hoc instrument built upon a validated screening tool for female athletes. Results: Most participants reported symptom fluctuations across menstrual phases, with many modifying or reducing exercise participation. A concerning number experienced daily undiagnosed pelvic floor symptoms, emphasizing needs for comprehensive medical evaluation. Conclusions: Exacerbated pelvic symptoms showed complex relationships with menstruation, highlighting the importance of considering the MC in customized clinical management approaches. Symptoms demonstrated differential links to menstruation, indicating needs for individualized evaluation and tailored treatment plans based on symptom profiles and hormonal interactions. Educating professionals and patients remains essential to enhancing awareness, detection, and therapeutic outcomes. Further controlled longitudinal research should elucidate intricate relationships between menstrual cycles and pelvic symptom variability. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

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12 pages, 292 KiB

Open AccessArticle

Sex Differences in the Atherogenic Risk Index in Healthy Mexican Population and Its Relationship with Anthropometric and Psychological Factors

by Aniel Jessica Leticia Brambila-Tapia, Ingrid Patricia Dávalos-Rodríguez, Carlos Adán Méndez-García, Frida Isadora Bárcenas-Robles and Itzae Adonai Gutiérrez-Hurtado

J. Pers. Med. 2023, 13(10), 1452; https://doi.org/10.3390/jpm13101452 - 29 Sep 2023

Cited by 1 | Viewed by 2359

Abstract

Dyslipidemia is a risk factor for cardiovascular disease and mortality; however, the association of this variable with a wide range of personal and psychological variables has not been researched. Therefore, the aim of this study was to compare lipid levels and anthropometric measures between sexes and to determine the association between personal and psychological variables with the atherogenic risk index (ARI). An adult population which auto-reported as healthy was invited to participate via social media and in person. They filled out a questionnaire with personal and psychological variables; in addition, the body mass index (BMI) and waist-to-hip ratio (WHR) were measured, and a blood sample was obtained to determine serum lipids. A total of 172 participants were included, from which 92 (53.49%) were women; both sexes were comparable in age and most sociodemographic values. Men showed significantly higher levels of total cholesterol, LDL cholesterol, triglycerides, ARI, and lower levels of HDL cholesterol. The men also showed higher values of WHR than the women. In the bivariate analysis, ARI showed the highest correlation with WHR (r = 0.664) in the men and with BMI (r = 0.619) in the women. In the multivariate analysis, the quality of food intake was negatively correlated with ARI in the global and women’s samples, and the psychological variables of assertiveness and positive relations with others were negatively correlated with ARI in women, while purpose in life was negatively correlated with ARI in men. In conclusion, the higher levels of serum lipids and ARI in men can be explained by the higher values of WHR in this sex. Behavioral and psychological variables could be protective factors for high ARI. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

Review

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17 pages, 328 KiB

Open AccessReview

Recommendations for the Application of Sex and Gender Medicine in Preclinical, Epidemiological and Clinical Research

by Annamaria Cattaneo, Maria Bellenghi, Eliana Ferroni, Cristina Mangia, Matteo Marconi, Paola Rizza, Alice Borghini, Lorena Martini, Maria Novella Luciani, Elena Ortona, Alessandra Carè, Marialuisa Appetecchia and Ministry of Health-Gender Medicine Team

J. Pers. Med. 2024, 14(9), 908; https://doi.org/10.3390/jpm14090908 - 27 Aug 2024

Viewed by 2082

Abstract

Gender medicine studies how health status and diseases differ between men and women in terms of prevention, therapeutic approach, prognosis, and psychological and social impact. Sex and gender analyses have been demonstrated to improve science, contributing to achieving real appropriateness and equity in the cure for each person. Therefore, it is fundamental to consider, both in preclinical and clinical research, the different clinical and biological features associated with sex and/or gender, where sex differences are mainly influenced by biological determinants and gender ones by socio-cultural and economic matters. This article was developed to provide knowledge and methodological tools for the development of studies/research protocols in which sex and gender should be taken into account. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

Other

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17 pages, 1456 KiB

Open AccessSystematic Review

Anatomical Features in Inguinal-Pubic-Adductor Area That May Contribute to Gender Difference in Susceptibility to Groin Pain Syndrome

by Gian Nicola Bisciotti, Andrea Bisciotti, Alessio Auci, Alessandro Bisciotti and Piero Volpi

J. Pers. Med. 2024, 14(8), 860; https://doi.org/10.3390/jpm14080860 - 14 Aug 2024

Viewed by 723

Abstract

Groin pain syndrome (GPS) is often a diagnostic challenge for sport physicians. Despite this diagnostic difficulty, the incidence of GPS in athletes is relatively high, afflicting 10–20% of the total sports population. In the literature, a certain number of studies demonstrate an important gender-based difference in the incidence of GPS in both sexes, with a ratio of female:male athletes clearly in favor of the female gender being relatively less prone to GPS. Indeed, some anatomical differences between the two sexes seem to represent a protective factor against the onset of GPS in women, although the current literature still needs to clarify the validity of these findings. It is the aim of this systematic review to examine all the anatomical differences between men and women that may be responsible for the difference in the onset of GPS in the two sexes. Full article

(This article belongs to the Special Issue Sex and Gender-Related Issues in the Era of Personalized Medicine)

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