BarcelonaGender inequality also affects scientific research. Since the number of men studied in clinical trials is greater than the number of women, the results obtained ultimately lead to treatments that favor the male gender more than the female gender. Regarding cell studies, the sex of the direct donor has always been an overlooked variable. Now, a study conducted by Catalan researcher Sergi Clotet-Frexas, head of the Gender and Sexual Sciences Research Group at McMaster University in Toronto, and researcher Anna Konvalenka, is looking at differences between men and women in kidney cell metabolism. This pioneering analysis has shown that these organs do not digest nutrients in the same way depending on biological sex, which explains why diabetic nephropathy, the leading cause of irreversible kidney dysfunction known as chronic kidney disease, develops more quickly in men, who are Also the main cause of chronic kidney failure. People who are most likely to suffer from it.
These conclusions were published in the journal science translational medicine, They suggest that the study of the female kidney, which has not yet been studied by the scientific community, could lay the foundations for a treatment that slows, prevents or cures this disease, which ends up being very limited; It requires living connected to a dialysis machine or having to have a kidney transplant. In addition, it will make it possible for treatments to be gender specific. how? “We have to see how we can make men's kidneys look like women's kidneys,” Clotet concludes at ARA.
Tubular cells are the most abundant and vibrant in the kidney. Between 70% and 90% of the organ is made up of these cells, which absorb glucose and other essential nutrients for the human body. The researchers analyzed their metabolism, that is, the way they “eat” to survive and perform their functions properly, in both men and women, and found different mechanisms depending on gender.
Inside these cells there is an army of molecules responsible for obtaining food: they take sugars, fatty acids, amino acids, etc., and break them into small pieces so that the cells can digest them and convert them into energy. Continuing the war analogy, this army has diverse forces and there is a bevy of metabolites known as the TCA cycle, which men have at higher levels. Clotet explains that it's “good” for these metabolites to work, but he warns that men with diabetes can become stressed when exposed to large amounts of glucose and do more than they should, which ultimately leads to the death of kidney cells and cells. Fibrosis of organ tissue. All this eventually leads to kidney failure. The researcher adds that when patients reach this stage, they must undergo dialysis or undergo a transplant, which means “a loss of quality of life and an increase in health care costs.”
On the other hand, women's kidneys do not contain high levels of these metabolites. In addition, the army of molecules that nourish female kidney cells has a soldier that performs the opposite function: it is a metabolite called pyruvate, which is present in women's kidneys much more than in men. The authors of the research have demonstrated that when higher levels of pyruvate are consumed, there is more protection against the development of diabetic kidney disease. According to Clotet, this ingredient acts as an antioxidant: “It attaches to molecules that generate stress and blocks them.” Women who lose the presence of pyruvate also have a greater risk of developing the disease, and this opens the door to searching for strategies that favor pyruvate accumulation in both men and women, while avoiding excessive activity of the TCA cycle. These extreme cases still need to be investigated in a sex-specific manner, in addition to intensified study of the mechanisms of prevention of diabetic kidney disease.
Twice the death rate among men
Once patients reach advanced stages of chronic kidney disease, the mortality rate over a five-year period is approximately 10%. Diabetes is the main cause of this disease, which affects 14% of the world's adult population. Therefore, the goal of these researchers is to better understand the mechanisms responsible for diabetic nephropathy and their differences by sex.
The first conclusions were drawn using laboratory cells, but to validate the results, they used data from two groups of people of different ages, with and without diabetes. Specifically, the GenoDiabMar group of the Hospital del Mar, in collaboration with researchers Clara Barrios and Marta Riera, which includes 650 patients with type 2 diabetes and different degrees of diabetic nephropathy, and another from Germany with records of about 5,400 people. Among this second group, Clotet explains, German researchers were able to observe that “men’s mortality was twice the rate of women’s.”
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