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Regitz-Zagrosek V, Gebhard C. Gender medicine: effects of sex and gender on cardiovascular disease manifestation and outcomes. Nat Rev Cardiol 2023; 20:236-247. [PMID: 36316574 PMCID: PMC9628527 DOI: 10.1038/s41569-022-00797-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Despite a growing body of evidence, the distinct contributions of biological sex and the sociocultural dimension of gender to the manifestations and outcomes of ischaemic heart disease and heart failure remain unknown. The intertwining of sex-based differences in genetic and hormonal mechanisms with the complex dimension of gender and its different components and determinants that result in different disease phenotypes in women and men needs to be elucidated. The relative contribution of purely biological factors, such as genes and hormones, to cardiovascular phenotypes and outcomes is not yet fully understood. Increasing awareness of the effects of gender has led to efforts to measure gender in retrospective and prospective clinical studies and the development of gender scores. However, the synergistic or opposing effects of sex and gender on cardiovascular traits and on ischaemic heart disease and heart failure mechanisms have not yet been systematically described. Furthermore, specific considerations of sex-related and gender-related factors in gender dysphoria or in heart-brain interactions and their association with cardiovascular disease are still lacking. In this Review, we summarize contemporary evidence on the distinct effects of sex and gender as well as of their interactions on cardiovascular disease and how they favourably or unfavourably influence the pathogenesis, clinical manifestations and treatment responses in patients with ischaemic heart disease or heart failure.
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Affiliation(s)
- Vera Regitz-Zagrosek
- Institute for Gender in Medicine, Charité University Medicine Berlin, Berlin, Germany.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, Inselspital Bern University Hospital, Bern, Switzerland
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Vader SS, Lewis SM, Verdonk P, Verschuren WM, Picavet HSJ. Masculine gender affects sex differences in the prevalence of chronic health problems - the Doetinchem Cohort Study. Prev Med Rep 2023; 33:102202. [DOI: 10.1016/j.pmedr.2023.102202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/01/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
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Kraus U, Jacke K, Dandolo L, Debiak M, Fichter S, Groth K, Kolossa-Gehring M, Hartig C, Horstmann S, Schneider A, Palm K, Bolte G. Operationalization of a multidimensional sex/gender concept for quantitative environmental health research and implementation in the KORA study: Results of the collaborative research project INGER. Front Public Health 2023; 11:1128918. [PMID: 37143983 PMCID: PMC10152671 DOI: 10.3389/fpubh.2023.1128918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/27/2023] [Indexed: 05/06/2023] Open
Abstract
Background In environmental health research, sex and gender are not yet adequately considered. There is a need to improve data collection in population-based environmental health studies by comprehensively surveying sex/gender-related aspects according to gender theoretical concepts. Thus, within the joint project INGER we developed a multidimensional sex/gender concept which we aimed to operationalize and to test the operationalization for feasibility. Methods In an iterative process, we created questionnaire modules which quantitatively captured the requirements of the INGER sex/gender concept. We deployed it in the KORA cohort (Cooperative Health Research in the Region of Augsburg, Germany) in 2019 and evaluated response and missing rates. Results The individual sex/gender self-concept was surveyed via a two-step approach that asked for sex assigned at birth and the current sex/gender identity. Additionally, we used existing tools to query internalized sex/gender roles and externalized sex/gender expressions. Adapted to the KORA population, we asked for discrimination experiences and care and household activities contributing to explain structural sex/gender relations. Further intersectionality-related social categories (e.g., socio-economic position), lifestyle and psychosocial factors were covered through data available in KORA. We could not identify appropriate tools to assess the true biological sex, sexual orientation and ethnic/cultural identity, which have yet to be developed or improved. The response-rate was 71%, the evaluation of 3,743 questionnaires showed a low missing rate. Prevalence of marginalized groups regarding sex/gender identity and definable by experiences of discrimination was very low. Conclusion We have shown how the multidimensional INGER sex/gender concept can be operationalized according to an European and North American understanding of sex/gender for use in quantitative research. The questionnaire modules proved feasible in an epidemiologic cohort study. Being a balancing act between theoretical concepts and its quantitative implementation our operationalization paves the way for an adequate consideration of sex/gender in environmental health research.
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Affiliation(s)
- Ute Kraus
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- *Correspondence: Ute Kraus
| | - Katharina Jacke
- Gender and Science Research Unit, Institute of History, Humboldt-University of Berlin, Berlin, Germany
| | - Lisa Dandolo
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Malgorzata Debiak
- Section II 1.2 Toxicology, Health-Related Environmental Monitoring, German Environment Agency, Berlin, Germany
| | - Sophie Fichter
- Section II 1.2 Toxicology, Health-Related Environmental Monitoring, German Environment Agency, Berlin, Germany
| | - Katrin Groth
- Section II 1.2 Toxicology, Health-Related Environmental Monitoring, German Environment Agency, Berlin, Germany
| | - Marike Kolossa-Gehring
- Section II 1.2 Toxicology, Health-Related Environmental Monitoring, German Environment Agency, Berlin, Germany
| | - Christina Hartig
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Sophie Horstmann
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Alexandra Schneider
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Kerstin Palm
- Gender and Science Research Unit, Institute of History, Humboldt-University of Berlin, Berlin, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
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van den Hurk L, Hiltner S, Oertelt-Prigione S. Operationalization and Reporting Practices in Manuscripts Addressing Gender Differences in Biomedical Research: A Cross-Sectional Bibliographical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14299. [PMID: 36361177 PMCID: PMC9653596 DOI: 10.3390/ijerph192114299] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Historically, authors in the biomedical field have often conflated the terms sex and gender in their research significantly limiting the reproducibility of the reported results. In the present study, we investigated current reporting practices around gender in biomedical publications that claim the identification of "gender differences". Our systematic research identified 1117 articles for the year 2019. After random selection of 400 publications and application of inclusion criteria, 302 articles were included for analysis. Using a systematic evaluation grid, we assessed the provided methodological detail in the operationalization of gender and the provision of gender-related information throughout the manuscript. Of the 302 articles, 69 (23%) solely addressed biological sex. The remaining articles investigated gender, yet only 15 (6.5%) offered reproducible information about the operationalization of the gender dimension studied. Followingly, these manuscripts also provided more detailed gender-specific background, analyses and discussions compared to the ones not detailing the operationalization of gender. Overall, our study demonstrated persistent inadequacies in the conceptual understanding and methodological operationalization of gender in the biomedical field. Methodological rigor correlated with more nuanced and informative reporting, highlighting the need for appropriate training to increase output quality and reproducibility in the field.
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Affiliation(s)
- Lori van den Hurk
- Department of Primary and Community Care, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands
| | - Sarah Hiltner
- Department of Primary and Community Care, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands
- AG10 Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, 33615 Bielefeld, Germany
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Raparelli V, Santilli F, Marra AM, Romiti GF, Succurro E, Licata A, Buzzetti E, Piano S, Masala M, Suppressa P, Becattini C, Muiesan ML, Russo G, Cogliati C, Proietti M, Basili S. The SIMI Gender '5 Ws' Rule for the integration of sex and gender-related variables in clinical studies towards internal medicine equitable research. Intern Emerg Med 2022; 17:1969-1976. [PMID: 35932381 PMCID: PMC9522660 DOI: 10.1007/s11739-022-03049-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/01/2022] [Indexed: 12/02/2022]
Abstract
Biological sex and sociocultural gender matter when it comes to health and diseases. They have been both proposed as the undeniable gateways towards a personalized approach in care delivery. The Gender Working Group of the Italian Society of Internal Medicine (SIMI) was funded in 2019 with the aim of promoting good practice in the integration of sex and gender domains in clinical studies. Starting from a narrative literature review and based on regular meetings which led to a shared virtual discussion during the national SIMI congress in 2021, the members of the WG provided a core operational framework to be applied by internal medicine (IM) specialists to understand and implement their daily activity as researchers and clinicians. The SIMI Gender '5 Ws' Rule for clinical studies has been conceptualized as follows: Who (Clinical Internal Medicine Scientists and Practitioners), What (Gender-related Variables-Gender Core Dataset), Where (Clinical Studies/Translational Research), When (Every Time It Makes Sense) and Why (Explanatory Power of Gender and Opportunities). In particular, the gender core dataset was identified by the following domains (variables to collect accordingly): relations (marital status, social support, discrimination); roles (occupation, caregiver status, household responsibility, primary earner, household dimension); institutionalized gender (education level, personal income, living in rural vs urban areas); and gender identity (validated questionnaires on personality traits). The SIMI Gender '5 Ws' Rule is a simple and easy conceptual framework that will guide IM for the design and analysis of clinical studies.
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Affiliation(s)
- Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Via dei Borsari 46, 44121, Ferrara, Italy.
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy.
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
| | - Francesca Santilli
- Department of Medicine and Aging, and Center for Advanced Studies and Technology (CAST), University of Chieti, Chieti, Italy
| | - Alberto Maria Marra
- Department of Translational Medical Sciences, Italy and Center for Pulmonary Hypertension, Thoraxklinic, Member of the German Center for Lung Research (DZL), "Federico II" University of Naples, University Hospital Heidelberg, Heidelberg, Germany
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Anna Licata
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo Medical School, Palermo, Italy
| | - Elena Buzzetti
- Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Piano
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine-DIMED, University and Hospital of Padua, Padua, Italy
| | - Maristella Masala
- Department of Internal Medicine, University of Sassari, Sassari, Italy
| | - Patrizia Suppressa
- Department of Internal Medicine and Rare Disease Centre "C. Frugoni" University Hospital of Bari, Bari, Italy
| | - Cecilia Becattini
- Internal and Cardiovascular Medicine-Stroke Unit, University of Perugia, Perugia, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giuseppina Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Chiara Cogliati
- Internal Medicine, Department of Biomedical and Clinical Sciences, L.Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milano, Milan, Italy
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Closing the gap: How women can benefit more from science, research, policies, and health services. MED 2022; 3:302-308. [DOI: 10.1016/j.medj.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022]
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Pohrt A, Kendel F, Demuth I, Drewelies J, Nauman T, Behlouli H, Stadler G, Pilote L, Regitz-Zagrosek V, Gerstorf D. Differentiating Sex and Gender Among Older Men and Women. Psychosom Med 2022; 84:339-346. [PMID: 35149636 DOI: 10.1097/psy.0000000000001056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to paradigmatically show the development of a gender score that can be used as either an adjustment or a matching variable to separate the effects of gender versus biological sex in a sample of older adults. METHODS Our sample comprised 1100 participants from the Berlin Aging Study II (52% women, mean [standard deviation] age = 75.6 [3.8] years). The gender score included a multitude of gender-related variables and was constructed via logistic regression. In models of health outcomes, it was used as an adjustment variable in regression analyses as well as a matching variable to match older men and women according to their gender. RESULTS Matching by gender substantially reduced sample size to n = 340. Analyses (either adjusting for gender or matching men and women according to gender) revealed that female sex was independently associated with lower grip strength (B = -14.47, 95% confidence interval [CI] = -15.51 to -13.44), better cognitive performance (B = 3.47, 95% CI = 1.94 to 5.0), higher pulse wave velocity (B = 0.19, 95% CI = 0.06 to 0.31), lower body mass index (B = -0.97, 95% CI = -1.74 to -0.21), and lower rates of metabolic syndrome (odds ratio = 0.53, 95% CI = 0.37 to 0.77). In addition, both sex and gender were independently associated with cognitive performance and depression. CONCLUSIONS Calculating a gender score allows for the inclusion of a large number of variables, creating parsimonious models that are adaptable to different data sets and alternative gender definitions. Depending on the research question and the sample properties, the gender score can be used as either an adjustment or a matching variable.Trial Registration: DRKS-Deutsches Register Klinischer Studien (Study ID: DRKS00016157).
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Affiliation(s)
- Anne Pohrt
- From the Gender in Medicine (Pohrt, Kendel, Nauman, Stadler, Regitz-Zagrosek), Institute of Biometry and Clinical Epidemiology (Pohrt), and Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism) (Demuth), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BCRT-Berlin Institute of Health Center for Regenerative Therapies (Demuth); Department of Psychology (Drewelies, Gerstorf), Humboldt University Berlin, Berlin, Germany; Department of Medicine (Behlouli, Pilote), Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada; Universität Zürich, Department of Cardiology (Regitz-Zagrosek), University Hospital Zürich, University of Zürich, Zürich, Switzerland; and Applied Health Sciences (Stadler), University of Aberdeen, Aberdeen, Scotland, United Kingdom
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Yuan J, Sang S, Pham J, Kong WJ. Gender Modifies the Association of Cognition With Age-Related Hearing Impairment in the Health and Retirement Study. Front Public Health 2021; 9:751828. [PMID: 34976918 PMCID: PMC8718684 DOI: 10.3389/fpubh.2021.751828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Despite growing recognition of hearing loss as a risk factor for late life cognitive disorders, sex and gender analysis of this association has been limited. Elucidating this is one means to advocate for holistic medicine by considering the psychosocial attributes of people. With a composite Gender Score (GS), we aimed to assess this among aging participants (50+) from the 2016 Health and Retirement Study (HRS) cohort. Methods: The GS was derived from gender-related variables in HRS by factor analyses and logistic regression, ranging from 0 (toward masculinity) to 100 (toward femininity). GS tertiles were also used to indicate three gender types (GS tertile 1: lower GS indicates masculinity; GS tertile 2: middle GS indicates androgyny; GS tertile 3: higher GS indicates femininity). Univariate followed by multiple logistic regressions were used to estimate the Odds Ratio (OR) and 95% confidence intervals (CI) of cognitive impairment (assessed by adapted Telephone Interview for Cognitive Status) from hearing acuity, as well as to explore the interactions of sex and gender with hearing acuity. The risk of cognitive impairment among hearing-impaired participants was assessed using multivariable models including sex and gender as exposure variables. Results: Five variables (taking risks, loneliness, housework, drinking, and depression) were retained to compute the GS for each participant. The distribution of GS between sexes partly overlapped. After adjusting for confounding factors, the OR for cognitive impairment associated with hearing impairment was significantly higher (OR = 1.65, 95% CI: 1.26, 2.15), and this association was not modified by female sex (OR = 0.77, 95% CI: 0.46, 1.27), but by androgynous gender (OR = 0.44, 95% CI: 0.24, 0.81). In the multivariable models for participants with hearing impairment, androgynous and feminine gender, as opposed to female sex, was associated with lower odds of cognitive impairment (OR of GS tertile 2 = 0.59, 95% CI: 0.41, 0.84; OR of GS tertile 3 = 0.60, 95% CI: 0.41, 0.87; OR of female sex = 0.78, 95% CI: 0.57, 1.08). Conclusions: Hearing impairment was associated with cognitive impairment among older people, and this association may be attenuated by a more feminine GS.
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Affiliation(s)
- Jing Yuan
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuping Sang
- School of Medicine, Yunnan University, Kunming, China
| | - Jessica Pham
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Wei-Jia Kong
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Demuth I, Banszerus V, Drewelies J, Düzel S, Seeland U, Spira D, Tse E, Braun J, Steinhagen-Thiessen E, Bertram L, Thiel A, Lindenberger U, Regitz-Zagrosek V, Gerstorf D. Cohort profile: follow-up of a Berlin Aging Study II (BASE-II) subsample as part of the GendAge study. BMJ Open 2021; 11:e045576. [PMID: 34162642 PMCID: PMC8230995 DOI: 10.1136/bmjopen-2020-045576] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The study 'Sex- and gender-sensitive prevention of cardiovascular and metabolic disease in older adults in Germany', the GendAge study, focuses on major risk factors for cardiovascular and metabolic diseases and on the development of major outcomes from intermediate phenotypes in the context of sex and gender differences. It is based on a follow-up examination of a subsample (older group) of the Berlin Aging Study II (BASE-II). PARTICIPANTS The GendAge study assessments took place between 22 June 2018 and 10 March 2020. A total of 1100 participants (older BASE-II subsample, aged ≥65 years) with baseline data assessed at least by one of the BASE-II partner sites were investigated in the follow-up. These participants had a mean age of 75.6 years (SD ±3.8), with a mean follow-up at 7.4 years (SD ±1.5). FINDINGS TO DATE Data from different domains such as internal medicine, geriatrics, immunology and psychology were collected, with a focus on cardiometabolic diseases and in the context of sex and gender differences. Diabetes mellitus type 2 was reported by 15.6% and 8.6% of men and women, respectively. In contrast, this disease was diagnosed in 20.7% of men and 13.3% of women, indicating that a substantial proportion of almost 30% was unaware of the disease. Echocardiography revealed that left ventricular ejection fraction was higher in women than in men, in agreement with previous reports. FUTURE PLANS A gender questionnaire assessing sociocultural aspects implemented as part of the follow-up described here will allow to calculate a gender score and its evaluation based on the newly collected data. At the same time, the other BASE-II research foci established over the past 10 years will be continued and strengthened by the BASE-II transition into a longitudinal study with follow-up data on the older subsample. TRIAL REGISTRATION NUMBER DRKS00016157.
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Affiliation(s)
- Ilja Demuth
- Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Verena Banszerus
- Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Johanna Drewelies
- Department of Psychology, Humboldt University of Berlin, Berlin, Berlin, Germany
| | - Sandra Düzel
- Center for Lifespan Psychology, Max-Planck-Institute for Human Development, Berlin, Germany
| | - Ute Seeland
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany
| | - Dominik Spira
- Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Esther Tse
- Berlin Institute for Gender in Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Julian Braun
- Si-M / "Der Simulierte Mensch" a science framework of Technische, Universitat Berlin andCharité - Universitatsmedizin Berlin, Berlin, Germany
- Regenerative Immunology and Aging, BIH Center for Regenerative Therapies, Charité Universitatsmedizin Berlin, Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lars Bertram
- Lübeck Interdisciplinary Platform for Genome Analytics, University of Lübeck, Lübeck, Germany
- Center for Lifespan Changes in Brain and Cognition (LCBC), Dept of Psychology, University of Oslo, Oslo, Norway
| | - Andreas Thiel
- Si-M / "Der Simulierte Mensch" a science framework of Technische, Universitat Berlin andCharité - Universitatsmedizin Berlin, Berlin, Germany
- Regenerative Immunology and Aging, BIH Center for Regenerative Therapies, Charité Universitatsmedizin Berlin, Berlin, Germany
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max-Planck-Institute for Human Development, Berlin, Germany
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
| | - Vera Regitz-Zagrosek
- DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany
- Berlin Institute for Gender in Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
- Department of Cardiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Denis Gerstorf
- Department of Psychology, Humboldt University of Berlin, Berlin, Berlin, Germany
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