Int J Arrhythm.  2024 Mar;25(1):1. 10.1186/s42444-023-00108-z.

Sex‑related differences of fatty acid‑binding protein 4 and leptin levels in atrial fibrillation: an updated review

Affiliations
  • 1Department of Cardiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
  • 2Department of Medicine, King Edward Medical University, Lahore, Pakistan
  • 3Department of Pathology, Khyber Girls Medical College, Peshawar, Pakistan
  • 4Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi, Pakistan
  • 5Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan
  • 6Department of Medicine, Peshawar Medical College, Peshawar, Pakistan
  • 7Department of Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad, Pakistan

Abstract

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia affecting millions of individuals worldwide and posing significant challenges to healthcare systems. The growing body of research has uncovered sex-related differences in AF pathophysiology, including the role of fatty acid-binding protein 4 (FABP4) and leptin as potential biomarkers. FABP4 and leptin, key adipokines involved in cardiovascular health, have been linked to inflammation, oxidative stress, and endothelial dysfunction, all of which may contribute to AF development. These adipokines exhibit sex-specific differences in their concentrations, with females generally showing higher FABP4 levels and males displaying distinct leptin profiles. Furthermore, hormonal influences, particularly estrogen, and testosterone, play significant roles in shaping AF risk and atrial remodeling. Estrogen is associated with cardioprotective effects, while testosterone may exert proarrhythmic effects. Understanding these sex-specific mechanisms could lead to more tailored and effective clinical management of AF. The future of AF research holds promise for precision medicine, novel therapeutic targets, artificial intelligence integration, and personalized care approaches. Emphasizing patient-centered care, telemedicine, and multidisciplinary collaboration can further enhance AF management and improve patient outcomes. In conclusion, recognizing and addressing sex-related factors in AF pathophysiology offer opportunities for gender-responsive interventions and advancements in AF management. Implementing these insights may pave the way for targeted therapies and improved quality of life for individuals affected by AF.

Keyword

Adipocytes; Arrhythmia; Metabolism; Metabolic syndrome
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