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TFOS DEWS二期、性别、荷尔蒙报告 TFOS DEWS II Sex, Gender, and Hormones Report

Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Golebiowski B, Hampel U, McDermott AM, Schaumberg DA, Srinivasan S, Versura P, MDP W

期刊名称:The Ocular Surface



摘要:干眼症最显著的特征之一是在女性身上发生较男性更加频繁。实际上,女性的性别是干眼症发展中的一个重要风险因素,造成干眼症发病率的性别差异很大程度上取决于性激素(例如雄激素、雌激素)、下丘脑-垂体激素、糖皮质激素、胰岛素、胰岛素样生长因子、甲状腺激素的影响。同时,性染色体因素及表观遗传学(例如micro RNA)也有影响,除了生物性别,社会性别也是干眼症的一个危险因素。"sex""gender"经常被替换使用,但它们有着截然不同的含义。gender指一个人作为男人或女人的自我表达,而sex是基于生物学特征对男性和女性的区分。这两种性别因素对干眼症的风险、表现、免疫反应、疼痛、就医行为、服务利用以及许多其他眼部健康方面均产生影响。总的来说,生物性别,社会性别以及荷尔蒙在眼表及附件组织的调节及男女差异导致不同患病率中起到重要作用。这篇小组委员会报告的目的是回顾并评价这一角色的性质,同时建议未来的研究领域应该旨在增进我们对生物性别、社会性别、荷尔蒙在干眼症中的相互关系的了解。


One of the most compelling features of dry eye disease (DED) is that it occurs more frequently in women than men. In fact, the female sex is a significant risk factor for the development of DED. This sex-related difference in DED prevalence is attributed in large part to the effects of sex steroids (e.g. androgens, estrogens), hypothalamic-pituitary hormones, glucocorticoids, insulin, insulin-like growth factor 1 and thyroid hormones, as well as to the sex chromosome complement, sex-specific autosomal factors and epigenetics (e.g. microRNAs). In addition to sex, gender also appears to be a risk factor for DED. "Gender" and "sex" are words that are often used interchangeably, but they have distinct meanings. "Gender" refers to a person's self-representation as a man or woman, whereas "sex" distinguishes males and females based on their biological characteristics. Both gender and sex affect DED risk, presentation of the disease, immune responses, pain, care-seeking behaviors, service utilization, and myriad other facets of eye health. Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men. The purpose of this Subcommittee report is to review and critique the nature of this role, as well as to recommend areas for future research to advance our understanding of the interrelationships between sex, gender, hormones and DED.


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