Respiratory medicine · 2026
Evidence of sex-related differences in vascular health among people with cystic fibrosis.
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Bajaj Pratima, Crandall Reva, Blackburn Marsha, Thomas Jeffrey, Taylor-Cousar Jennifer L, Harris Ryan A
Аннотация
BACKGROUND: Cystic fibrosis (CF) is a genetic condition that can cause multisystem damage that progresses into life-threatening complications. Sex differences in CF-related outcomes have been reported such that females with CF experience increased morbidity and mortality earlier in the disease course compared to males. The mechanisms that contribute to these sex differences in clinical outcomes, however, have yet to be fully elucidated. Since CF is known to have cardiac sequelae, and sex differences in CVD also exist in the general population, the present investigation sought to comprehensively evaluate vascular health in males and females with CF to gain insight into these sex disparities.
METHODS: Twenty-two individuals with CF (12 male and 10 female) participated in this cross-sectional study. Aortic stiffness was assessed using pulse wave analysis (PWA), and central arterial stiffness was determined by carotid to femoral pulse wave velocity (cfPWV). Conduit vessel endothelial function was evaluated using the flow-mediated dilation (FMD) test, and microvascular endothelial function was determined using laser Doppler imaging following cutaneous reactive hyperemia, local thermal heating, and iontophoresis with acetylcholine.
RESULTS: Females were significantly (p = 0.035) younger compared to males. Controlling for age, PWA was significantly (p < 0.001; Cohen's d = -1.990) higher in females (24.1 ± 7.5%) compared to males (7.2 ± 9.2%) while cfPWV was similar (p = 0.756; Cohen's d = 0.693) between groups. FMD (p = 0.547; Cohen's d = 0.208), post-occlusive reactive hyperemia (p = 0.721; Cohen's d = 0.568), and local thermal heating responses (p = 0.100; Cohen's d = -0.392) were all similar between males and females with CF. Although a significant (p < 0.001) increase in cutaneous perfusion in response to acetylcholine was observed in both groups, the peak response to acetylcholine iontophoresis was significantly (p = 0.002; Cohen's d = -1.384) higher in females compared to males.
CONCLUSIONS: Overall findings indicate that sex differences in vascular health are observed in people with CF and demonstrate that the CF pathophysiology may impact vascular beds differently dependent on sex.
METHODS: Twenty-two individuals with CF (12 male and 10 female) participated in this cross-sectional study. Aortic stiffness was assessed using pulse wave analysis (PWA), and central arterial stiffness was determined by carotid to femoral pulse wave velocity (cfPWV). Conduit vessel endothelial function was evaluated using the flow-mediated dilation (FMD) test, and microvascular endothelial function was determined using laser Doppler imaging following cutaneous reactive hyperemia, local thermal heating, and iontophoresis with acetylcholine.
RESULTS: Females were significantly (p = 0.035) younger compared to males. Controlling for age, PWA was significantly (p < 0.001; Cohen's d = -1.990) higher in females (24.1 ± 7.5%) compared to males (7.2 ± 9.2%) while cfPWV was similar (p = 0.756; Cohen's d = 0.693) between groups. FMD (p = 0.547; Cohen's d = 0.208), post-occlusive reactive hyperemia (p = 0.721; Cohen's d = 0.568), and local thermal heating responses (p = 0.100; Cohen's d = -0.392) were all similar between males and females with CF. Although a significant (p < 0.001) increase in cutaneous perfusion in response to acetylcholine was observed in both groups, the peak response to acetylcholine iontophoresis was significantly (p = 0.002; Cohen's d = -1.384) higher in females compared to males.
CONCLUSIONS: Overall findings indicate that sex differences in vascular health are observed in people with CF and demonstrate that the CF pathophysiology may impact vascular beds differently dependent on sex.