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Gender and Lipids in Coronary Artery Disease

Jesse C. Krakauer, MD; J. David Fachnie, MD
Arch Intern Med. 1991;151(9):1881. doi:10.1001/archinte.1991.00400090147029.
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To the Editor.—  The article by Reinhart et al1 deserves special attention because of the inclusion of women (31%) into the study. Indeed, the authors found differences between men and women in the predictive power of certain lipoprotein and apolipoprotein (apo) measurements. In men, coronary artery disease was associated with elevated levels of apo B, total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol in serum and depressed apo A-I/B ratio. In women, coronary artery disease was associated with elevated apo B and triglyceride levels and depressed apo A-I/B ratio.These differences are worthy of note, because the expression of coronary artery disease in men is different from that in women and these differences are at least partially due to the sex-steroid milieu.2 The contribution of menopause to the lipid profile may, in fact, be small,3 but that of replacement sex hormones appears definite, albeit complex.4


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