2023 Volume 50 Issue 5 Pages 460-466
The concept of gender-specific medicine began with a review of women's healthcare in the USA. In Japan, the concept of gender-specific medicine was introduced by the author at the Japanese Society of Cardiology in 1999. Lifestyle-related diseases are diseases in which lifestyle habits such as diet, exercise, rest, smoking and alcohol consumption are deeply involved and contribute to their development. Factors contributing to health and ill-health can be broadly divided into (1) Sex (biological differences) and (2) Gender (psychosocial or cultural differences). Factors such as diet, exercise, rest, smoking and alcohol consumption are often discussed in the Gender domain, but the factor that contributes more significantly to lifestyle-related diseases is Sex (differences in sex hormone levels within, between individuals and between men and women). The changes that begin with a lack of estrogen first appear in health check-up data. In a project carried out by Chiba Prefecture between 2002 and 2006, data were collected on a total of 366,862 men and women aged 35 and over, and the results were used to assess obesity, blood pressure, lipids (total cholesterol, LDL cholesterol, neutral fat), liver function (ALT, γ-GTP), creatinine and blood glucose levels (γ-GTP). GTP) and creatinine, with clear gender- and age-specific changes (especially in women at menopausal age). There are two types of estrogen receptor, α and β. The estrogen receptor ERα was discovered in 1966 and the estrogen receptor ERβ in 1996; ERα is mainly distributed in organs involved in female reproduction such as the mammary gland and uterus, whereas ERβ is more widely distributed throughout the body in both sexes and has more extensive physiological significance. Estrogens have anti-atherosclerotic effects such as improvement of blood lipid metabolism, activation of NO synthase from vascular endothelial cells and antioxidant action, and insulin action and cardioprotective effects have also been reported ERβ is also known to be expressed at higher levels in the brain compared to ERα. It is also present in the hippocampus, which is responsible for cognition. In the 100 years of life, a thorough understanding of the relationship between the life cycles of men and women and sex hormones will undoubtedly increase the effectiveness of guidance on the prevention of lifestyle-related diseases.