| Title: | Sex Differences in Lipids and Lipoproteins and Their Relationship With Cardiovascular Disease: A Prospective Study of UK Biobank Participants. |
| Journal: | Journal of the American Heart Association |
| Published: | 9 Apr 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41954057/ |
| DOI: | https://doi.org/10.1161/jaha.125.045533 |
Publication 18049
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Abstract
BACKGROUND: Sex-specific differences in serum lipids are recognized, but their relationship with cardiovascular disease (CVD) has not been reliably quantified. We examined sex-specific associations of major lipids and apolipoproteins with incident CVD.</p>
METHODS: We included 432 092 UK Biobank participants without CVD at baseline (2006-2010) and with ≥1 lipid measurement. Age-adjusted risks were estimated using Poisson regression. Multivariable Cox models estimated hazard ratios (HRs) and women-to-men ratios of HRs for 1-SD higher values of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apoB (apolipoprotein B), apoA1 (apolipoprotein A1), and Lp(a) (lipoprotein [a]).</p>
RESULTS: Over a mean 13.3 years of follow-up, there were 10 699 and 18 950 cases of CVD in women and men, respectively. CVD risk per 10 000 person-years was 33.4 (95% CI, 32.7-34.0) for women and 76.6 (95% CI, 75.5-77.7) for men. Low-density lipoprotein cholesterol, apoB, and log Lp(a) were associated with smaller HRs of CVD for women than men (ratio of HR, 0.94 [95% CI, 0.91-0.97], ratio of HR, 0.94 [95% CI, 0.92-0.97] and ratio of HR, 0.96 [95% CI, 0.93-0.99], respectively). Triglycerides were associated with larger HRs of CVD in women than men (ratio of HR, 1.06 [95% CI, 1.02-1.09]). The association of lower apoA1 with higher CVD risk was stronger in men than women (ratio of HR, 1.06 [95% CI, 1.03-1.10]). No sex difference was observed for high-density lipoprotein cholesterol (ratio of HR, 1.02 [95% CI, 0.98-1.06]).</p>
CONCLUSIONS: Men had a higher rate of CVD than women overall. Low-density lipoprotein cholesterol, apoB and Lp(a) had stronger associations with CVD risk in men, whereas triglycerides were stronger in women. ApoA1 was less protective for CVD in women than men.</p>
22 Keywords
- Adult
- Aged
- Apolipoprotein A-I
- Apolipoprotein B-100
- Biological Specimen Banks
- Biomarkers
- Cardiovascular Diseases
- Cholesterol, LDL
- Female
- Humans
- Incidence
- Lipids
- Lipoprotein(a)
- Male
- Middle Aged
- Prospective Studies
- Risk Assessment
- Risk Factors
- Sex Factors
- Triglycerides
- UK Biobank
- United Kingdom
4 Authors
- Rebecca K Kelly
- Katie Harris
- Paul Muntner
- Mark Woodward
1 Application
| Application ID | Title |
|---|---|
| 74018 | Sex differences in the determinants and outcomes of multimorbidity clusters and their constituent conditions in the UK Biobank Study |
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