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Review
. 2021 Jul 19;10(14):3178.
doi: 10.3390/jcm10143178.

Gender and Sex Are Key Determinants in Osteoarthritis Not Only Confounding Variables. A Systematic Review of Clinical Data

Matilde Tschon  1 , Deyanira Contartese  1 , Stefania Pagani  1 , Veronica Borsari  1 , Milena Fini  1
Affiliations
Review

Gender and Sex Are Key Determinants in Osteoarthritis Not Only Confounding Variables. A Systematic Review of Clinical Data

Matilde Tschon et al. J Clin Med. .

Abstract

Many risk factors for osteoarthritis (OA) have been noted, while gender/sex differences have been understated. The work aimed to systematically review literature investigating as primary aim the relationship between gender/sex related discriminants and OA. The search was performed in PubMed, Science Direct and Web of Knowledge in the last 10 years. Inclusion criteria were limited to clinical studies of patients affected by OA in any joints, analyzing as primary aim gender/sex differences. Exclusion criteria were review articles, in vitro, in vivo and ex vivo studies, case series studies and papers in which gender/sex differences were adjusted as confounding variable. Of the 120 records screened, 42 studies were included. Different clinical outcomes were analyzed: morphometric differences, followed by kinematics, pain, functional outcomes after arthroplasty and health care needs of patients. Women appear to use more health care, have higher OA prevalence, clinical pain and inflammation, decreased cartilage volume, physical difficulty, and smaller joint parameters and dimensions, as compared to men. No in-depth studies or mechanistic studies analyzing biomarker differential expressions, molecular pathways and omic profiles were found that might drive preclinical and clinical research towards sex-/gender-oriented protocols.

Keywords: clinical studies; gender; men; osteoarthritis; patients; sex; women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Search strategy according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Figure 2
Figure 2
Prevalence of men and women analyzed in the included studies.
Figure 3
Figure 3
Diagram of percentages of included studies grouped by clinical endpoints investigated.
Figure 4
Figure 4
Frequencies (%) of risk of bias assessment according to the National Institutes of Health (NIH) quality assessment tool for observational cohort and cross-sectional studies (https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools).
Figure 5
Figure 5
Major findings between men and women in OA.
See this image and copyright information in PMC

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