Autism spectrum disorder involves challenges in social communication and restricted, repetitive behaviors. Historically, males have received autism diagnoses at comparatively high rates, prompting an underrepresentation of females in research and an incomplete understanding of sex-specific symptom presentations and comorbidities. This review examines sex differences in the prevalence of common comorbidities of autism to inform tailored clinical practices. These conditions include attention deficit hyperactivity disorder, anxiety disorders, conduct disorder, depression, epilepsy, intellectual disability, and tic disorders. Attention deficit hyperactivity disorder is prevalent in both sexes; however, females may more frequently exhibit the inattentive subtype. Anxiety disorders display inconsistent sex differences, while conduct disorder more frequently impacts males. Depression becomes more common with age; some studies indicate more pronounced symptoms in adolescent girls, while others suggest greater severity in males. Epilepsy is more prevalent in females, especially those with intellectual disabilities. Despite displaying a male predominance, intellectual disability may exacerbate the severity of autism to a greater degree in females. No clear sex differences have been found regarding tic disorders. Overall, contributors to sex-based differences include biases stemming from male-centric diagnostic tools, compensatory behaviors like camouflaging in females, genetic and neurobiological differences, and the developmental trajectories of comorbidities. Recognizing these factors is crucial for developing sensitive diagnostics and sex-specific interventions. Inconsistencies in the literature highlight the need for longitudinal studies with large, diverse samples to investigate autism comorbidities across the lifespan. Understanding sex differences could facilitate earlier identification, improved care, and personalized interventions, thus enhancing quality of life for individuals with autism.
Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven primarily by atherogenesis. Recent efforts to understand sex differences in CAD have revealed distinct patterns in disease burden, risk factors, and clinical presentations. This review examines these sex differences in CAD, underscoring the importance of customized diagnostic and management strategies. Although men typically have higher rates of CAD prevalence and incidence, women face unique challenges, such as delayed diagnosis, atypical symptoms, and lower rates of medication prescription. Hormonal, genetic, and lifestyle factors all play a role in these disparities, with estrogen notably reducing CAD risk in women. Nontraditional risk factors, including chronic inflammation, psychological stress, socioeconomic status, and reproductive history, also contribute to CAD development and are often neglected in clinical settings. Addressing these differences requires increased awareness, more accurate diagnosis, and equitable healthcare access for both sexes. Furthermore, greater inclusion of women in CAD research is essential to better understand sex-specific mechanisms and optimize treatment outcomes. Personalizing CAD management based on sex-specific knowledge has the potential to improve prognosis and decrease disease incidence for both men and women.
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