Circulating Sex-specific Markers of Plaque Instability in Women and Men with Severe Carotid Atherosclerosis
Bibliographic record
Abstract
Abstract Background Differences in plaque composition and instability exist among men and women. Circulating markers that reflect sex-specific features in the plaque should be explored for better prediction of high-risk plaques in women and in men. This study aims to 1) investigate differences in the lipid, immune, and adipokine circulating profiles of men and women with stable versus unstable plaques, and 2) identify circulating markers that can better classify men and women according to plaque instability. Methods Pre-operative blood samples as well as plaque specimens were collected from men and women undergoing a carotid endarterectomy (n=460). Blood samples were used for adipokine, lipid, and immune profiling. Plaque stability was determined by gold-standard histological classifications. Results Men had more unstable plaques than women (P<0.001), exhibiting greater plaque hemorrhage, a larger lipid core, and more inflammation (P<0.001), as well as less favourable circulating profiles. Significant antagonistic interactions were observed between sex and white blood cell (WBC) counts, sex and basophil to WBC ratio, and sex and platelet counts on impacting plaque instability. Several circulating immune parameters served as independent sex-specific markers of plaque instability; low total white blood cell (WBC) counts, high monocyte to WBC ratio, and low basophil to WBC ratio were associated with greater plaque instability in men, while a higher basophil to WBC ratio was observed in women with unstable plaques. Conclusions Our findings demonstrated sex-specific differences between older men and postmenopausal women with severe carotid atherosclerosis, with women displaying more stable plaque phenotypes, and favourable circulating profiles compared to men. We identified several potential circulating markers that relate to sex-specific plaque phenotypes for better prediction of high-risk plaques in women and in men. Following future validation, these markers could be implemented into clinical practice to monitor when the plaque becomes unstable and better select men and women for intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".