GENDER DIFFERENCES: DISEASE INCIDENCE AND SUSCEPTIBILITY TO

DISEASES
1) Obesity
What is Obesity?
Obesity is a condition in which a person has excessive body fat in relation to their
weight. There are different ways in which body fat in relation to total weight can
be detected the most common one being BMI (body mass index).
Class BMI Range
Healthy Weight 18.5 24.9
Overweight 25 29.9
Obese 30 39.9
Severely Obese 40+

What are the differences in prevalence of obesity between genders?

The prevalence of obesity in the UK in men and woman is relatively similar, but
slightly higher in men (approximately 26.0% in men and 23.8% in women). In
general, men are more likely to be overweight than women with 67.1% of men
and 58.2% of women being overweight or obese. Obesity is projected to affect
60% of men and 50% of women by 2050.
What are the risks associated with obesity, are they the same for men
and women?
Being obese increases the risk of developing a range of conditions including
hypertension, coronary heart disease, stroke, type 2 diabetes and colonic cancer
along with several other conditions. Men who are obese are five times more
likely to develop type 2 diabetes and nearly three times more likely to develop
high blood pressure. They are also two and a half times more likely to develop
erectile dysfunction compared to men of healthy weight due to the decreased
level of testosterone associated with obesity.
In obese women, developing type 2 diabetes is thirteen times more likely and
developing hypertension is over four times more likely. Obesity increases the risk
of developing polycystic ovary syndrome which leads to menstrual irregularities,
excessive hair growth and infertility. PCOS also affects the action of insulin which
increases the risk of type 2 diabetes.

2) Coronary Heart Disease

General Facts & Incidence

Coronary Heart Disease (CHD) Narrowing of arteries that deliver blood and
oxygen to the heart
Worldwide, coronary heart disease causes more than 7.4 million deaths
annually and it accounts for the largest percentage of cardiovascular
diseases.
Incidence: The incidence of a disease represents the number of new cases
that develop within a population over a specified period of time.
In all years between 2010/11 and 2013/14
 oThere has been a small continuous decline in the number of inpatient
episodes due to coronary heart disease (CHD) in both men and women
o the incidence of CHD in men was close to approximately double in women
Susceptibility
Risk Factors:
1. Increasing age
2. Men than women before the menopause
3. Family History of CHD
4. Diabetes
5. Smoking
Every year, 1 out of 10 women and 1 out of 6 men in the UK die from
coronary heart disease
Men are generally more affected by coronary heart disease than women.
Women tend to get coronary heart diseases 5-10 years later than men. Risk
of getting coronary heart diseases increases at the age of 55 for women and
45 for men.

3) OSTEOPOROSIS
Osteoporosis is a progressive systemic skeletal disease characterized by low
bone mass and microarchitecture deterioration of bone tissue, leading to
enhanced bone fragility and a consequent increase in fracture risk.

Incidence
Osteoporosis is estimated to affect 200 million women worldwide -
approximately one-tenth of women aged 60, one-fifth of women aged 70, two-
fifths of women aged 80 and two-thirds of women aged 90
In the UK, it is estimated that around 3 million people suffer from Osteoporosis.
One out of three women and one in five men more than 50 years of age are at
danger of an osteoporosis-related fracture in their lifetime.
Overall, 61% of osteoporotic fractures occur in women, with a female-to-male
ratio of 3:2
The overall mortality is about 20% in the first 12 months after hip fracture due
to either complications related to the broken bone itself or the surgery to repair it
By 2050, the worldwide incidence of hip fracture in men is projected to increase
by 240% in women and 310% in men, compared to rates in 1990
The prevalence of osteoporosis increases markedly with age, from 2% at 50
years to more than 25% at 80 years in women.

Susceptibility

Osteoporosis can affect people of any gender, but women make up the majority
of cases. This is mainly due to dramatic drops in oestrogen production during
menopause. Estrogen is effective in inhibiting bone resorption and increasing
Bone Mineral Density by binding to estrogen receptors on the bone.
Differences in fracture risk between men and women are mainly due to
differences in areal Bone Mineral Density, bone size, bone geometry, and bone
strength.
Other risk factors include a small thin frame, a family history of Osteoporosis,
smoking, excess alcohol intake, a lack of exercise, a deficiency in calcium intake,
and certain medicines such as steroids.
Medical conditions that include: diabetes, hyperthyroidism, anorexia, chronic
bronchitis and emphysema may also make you more susceptible to
Osteoporosis.

4) ASTHMA

What is asthma?
Common chronic condition that affects the airways resulting in the narrowing and
inflammation of the bronchial tubes.
Incidence in UK?

-5.4 million people have asthma in the U.K, with an estimated 334 million people
worldwide.
-This correlates to 1 in 11 people having asthma in the U.K.
-3 people die from asthma daily in the U.K.
-NHS spends approximately 1 billion pound on treating and caring for individuals
with asthma.

Incidence across men and women?

According to the American college on asthma and allergy, in children under the
age of 12, more boys have asthma than girls. As they grow in to puberty, the
ratio changes with more girls having asthma than boys.
Women aged between 20-50 are:
-30% more likely to have asthma than men
-40% more likely to suffer from an asthma attack and die
-3x more likely to be hospitalised due to asthma despite comparable spirometer
results.

Studies have demonstrated a link between asthma and the menstrual cycle,
however its yet to be validated.
For an average woman with a menstrual cycle of 28 days, during the last week
leading up to your period, starting from about day 22, the hormones
progesterone and oestrogen are in decline, with the lowest point being on day
28.
The declining levels of these 2 hormones results in either; constriction of the
airways of affects the cells of the immune system in some way which
predisposed the individual to an asthma attack. Blood vessels also form and
disappear as the woman's hormones fluctuate, which can increase or decrease
the ability of the lungs to take in oxygen

References
Kanis JA (2007) WHO Technical Report, University of Sheffield, UK: 66.
Melton LJ, 3rd, Atkinson EJ, O'Connor MK, et al. (1998) Bone density and fracture
risk in men. J Bone Miner Res 13:1915.
Seeman E (1995) The dilemma of osteoporosis in men. Am J Med 98:76S
http://www.nhs.uk/conditions/Obesity/Pages/Introduction.aspx
https://www.noo.org.uk/NOO_about_obesity/adult_obesity/UK_prevalence_and_tre
nds
http://www.nhs.uk/Livewell/loseweight/Pages/statistics-and-causes-of-the-obesity-
epidemic-in-the-UK.aspx
http://content.digital.nhs.uk/catalogue/pub16988/obes-phys-acti-diet-eng-
2015.pdf