1. Sexual dimorphism in articular tissue anatomy - Key to understanding sex differences in osteoarthritis?
- Author
-
Eckstein F, Wirth W, and Putz R
- Subjects
- Humans, Female, Male, Knee Joint diagnostic imaging, Knee Joint pathology, Sex Factors, Osteoarthritis diagnostic imaging, Osteoarthritis pathology, Menisci, Tibial diagnostic imaging, Menisci, Tibial pathology, Menisci, Tibial anatomy & histology, Radiography, Ligaments, Articular anatomy & histology, Ligaments, Articular pathology, Ligaments, Articular diagnostic imaging, Cartilage, Articular pathology, Cartilage, Articular diagnostic imaging, Sex Characteristics, Osteoarthritis, Knee diagnostic imaging, Osteoarthritis, Knee pathology
- Abstract
Objective: Osteoarthritis (OA) prevalence and incidence varies between women and men, but it is unknown whether this follows sex-specific differences in systemic factors (e.g. hormones) and/or differences in pre-morbid joint anatomy. We recognize that classifications of sex within humans cannot be reduced to female/male, but given the lack of literature on non-binary individuals, this review is limited to the sexual dimorphism of articular morphotypes., Methods: Based on a Pubmed search using relevant terms, and input from experts, we selected articles based on the authors' judgment of their relevance, interest, originality, and scientific quality; no "hard" bibliometric measures were used to evaluate their quality or importance. Focus was on clinical rather than pre-clinical studies, with most (imaging) data being available for the knee joint., Results: After introducing "sexual dimorphism", the specific literature on articular morphotypes is reviewed, structured by: radiographic joint space width (JSW), meniscus, ligaments, articular cartilage morphology, articular cartilage composition and deformation, and articular tissue response to treatment., Conclusions: Sex-specific differences were clearly observed for JSW, meniscus damage, ligament size, and cartilage morphometry (volume, thickness, and surface areas) but not for cartilage composition. Ligament and cartilage measures were smaller in women even after matching for confounders. Taken together, the findings indicate that female (knee) joints may be structurally more vulnerable and at greater risk of OA. The "one size/sex fits all" approach must be abandoned in OA research, and all observational and interventional studies should report their results for sex-specific strata, at least in pre-specified secondary or post-hoc analyses., Competing Interests: Declaration of Competing Interest Felix Eckstein and Wolfgang Wirth are employees of Chondrometrics GmbH, a company providing professional image analysis service to researchers in academia and to the pharmaceutical industry. Felix Eckstein, Wolfgang Wirth and Reinhard Putz are owners of Chondrometrics GmbH. Felix Eckstein has provided consulting services to Merck KGA, Kolon Tissuegene (KTG), Galapagos, Novartis, 4 P Pharma, and Formation Bio. Felix Eckstein and Wolfgang Wirth have received funding from multiple sources, including public bodies and the pharmaceutical industry (detailed list upon request)., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF