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Biomarkers for Abdominal Aortic Aneurysms From a Sex Perspective
Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden .
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Karolinska Institute, Stockholm, Sweden.
Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden .
Karolinska Institute, Stockholm, Sweden.
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2012 (English)In: Gender Medicine, ISSN 1550-8579, Vol. 9, no 4, 259-266 p.Article in journal (Refereed) Published
Abstract [en]


Abdominal aortic aneurysms (AAAs) differ in men and women. Women are older at diagnosis, have a higher risk of rupture, and worse outcome after surgery compared with men. The higher occurrence of AAAs in men accounts for the dominance of men in biomarker analyses.


The primary aim of this study was to investigate levels of established biomarkers for AAA in men and women, and the secondary aim was to compare biomarker levels in women with and without AAAs.


In this prospective case-control study, blood samples were collected from 16 women and 18 men with AAAs ≥5.5 cm, from 20 women with AAAs <5.5 cm, and from 18 women with peripheral artery disease (PAD). Plasma concentrations of matrix metalloproteinase (MMP) -2, -9, and -13; tissue inhibitor of MMP-1 (TIMP-1); plasminogen activator inhibitor 1 (PAI-1); high-sensitivity C-reactive protein (hsCRP); and estradiol levels were analyzed by ELISA. An ultrasound examination was performed in women with PAD to exclude an AAA.


Age and other comorbid conditions were similar between men and women with AAAs. Women with AAAs had higher levels of MMP-9 compared with men with equally large AAAs (42.8 ng/mL vs 36.2 ng/mL, P = 0.036) and lower levels of estradiol (30.0 pmoL vs 86.5 pmol/L, P < 0.001). Women with AAAs had lower levels of MMP-9 compared with women without (59.5 ng/mL vs 132.6 ng/mL, P = 0.010). There was no significant difference in the plasma levels of MMP-2, MMP-13, hsCRP, PAI-1, TIMP-1, and estradiol between women with and without AAAs.


The higher levels of MMP-9 in women compared with men with equally large AAAs could suggest that MMP-9 is a biomarker related to the sex differences in aneurysm development. The lower levels of estradiol in women with AAAs compared with men suggest that the possible protective effect of endogenous estrogen cannot be explained by a difference in circulating levels of estradiol.

Place, publisher, year, edition, pages
Elsevier, 2012. Vol. 9, no 4, 259-266 p.
Keyword [en]
abdominal aortic aneurysm; biomarker; sex differences; vascular disease
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-100329DOI: 10.1016/j.genm.2012.05.002ISI: 000307860900006PubMedID: 22721599OAI: diva2:661718
Available from: 2013-11-04 Created: 2013-11-04 Last updated: 2014-03-17Bibliographically approved

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Wågsäter, Dick
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