Regulatory Role of Sex Hormones in Cardiovascular Calcification

Abstract

Sex differences in cardiovascular disease (CVD), including aortic stenosis, atherosclerosis and cardiovascular calcification, are well documented. High levels of testosterone, the primary male sex hormone, are associated with increased risk of cardiovascular calcification, whilst estrogen, the primary female sex hormone, is considered cardioprotective. Current understanding of sexual dimorphism in cardiovascular calcification is still very limited. This review assesses the evidence that the actions of sex hormones influence the development of cardiovascular calcification. We address the current question of whether sex hormones could play a role in the sexual dimorphism seen in cardiovascular calcification, by discussing potential mechanisms of actions of sex hormones and evidence in pre-clinical research. More advanced investigations and understanding of sex hormones in calcification could provide a better translational outcome for those suffering with cardiovascular calcification.

Gender-Related Differences in Chronic Kidney Disease-Associated Vascular Calcification Risk and Potential Risk Mediators: A Scoping Review

“…However, there are also studies suggesting that estrogen analogs could aggravate VSMC calcification [206]. These findings indicate that the influence of estrogen on VC can be complex and scenario-dependent, unlike that exerted by testosterone, which is consistently pro-calcific [207]. Several other features can further modify these gender-related differences in VC risk, including the higher serum phosphate, FGF-23, and PTH levels observed in female CKD patients (Table 1).…”

MFG-E8 promotes osteogenic transdifferentiation of smooth muscle cells and vascular calcification by regulating TGF-β1 signaling

“…1a, b , the treatment of CaCl 2 on ligated CCAs significantly increased the endogenous level of MFG-E8 in the neointima and media relative to that of phosphate-buffered saline (PBS). Because sex differences in vascular stiffness have been reported 34 , we subsequently analyzed these differences. As illustrated in Supplementary Fig.…”

Integrative analyses of biomarkers and pathways for heart failure

“…When mineral components in the blood are deposited in blood vessels or heart valves, cardiovascular calcification can occur, including vascular calcification and heart valve calcification. According to its location, cardiovascular calcification can be divided into three types: atherosclerotic intimal vascular calcification, medial vascular calcification and aortic valve calcification [ 31 ]. Studies have shown that the occurrence of cardiovascular calcification has become a predictor of cardiovascular disease-related risks [ 32 ].…”