Sex differences in proatherogenic cytokine levels

Stella Bernardi, Barbara Toffoli, Federica Tonon, Morena Francica, Elena Campagnolo, Tommaso Ferretti, Sarah Comar, Fabiola Giudici, Elisabetta Stenner, Bruno Fabris

Research output: Contribution to journalArticlepeer-review


Background: It has been shown that sex affects immunity, including cytokine production. Given that atherosclerosis is an inflammatory disease promoted by specific cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, we aimed at evaluating whether sex could affect the levels of these proatherogenic cytokines in a group of healthy adults. In this analysis, we also included other cytokines and peptides that have been implicated in atherosclerosis development and progression. Methods: A total of 104 healthy adults were recruited; we measured circulating levels of IL-1β, IL-6, TNF-α, angiotensins and angiotensin-converting enzyme-2 (ACE2), as well as osteoprotegerin and receptor activator of nuclear factor κB ligand (RANKL). Results: IL-1β, IL-6, and TNF-α were significantly higher in men as compared to women. They were all associated with testosterone and the testosterone/estradiol ratio. They remained significantly associated with sex (but not with hormones) after being tested for potential confounders. Conclusions: Sex seems to influence the levels of proatherogenic cytokines. This is consistent not only with sex differences in vulnerability to infections but also with the higher cardiovascular risk exhibited by the male gender as compared to the female gender. Nevertheless, this association is only partly explained by hormone levels.

Original languageEnglish
Article number3861
JournalInternational Journal of Molecular Sciences
Issue number11
Publication statusPublished - Jun 1 2020


  • ACE2
  • Atherosclerosis
  • Cytokines
  • Gender
  • Healthy adults
  • IL-1β
  • IL-6
  • Inflammation
  • OPG
  • Sex
  • TNF-α

ASJC Scopus subject areas

  • Catalysis
  • Molecular Biology
  • Spectroscopy
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Inorganic Chemistry


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