Sex- and Age-Related Differences in Inflammatory Markers and Their Association with Coronary Artery Disease

INTRODUCTION: This study explored the differences in circulating cytokines between sexes and age and their association with the pathogenesis of coronary artery disease (CAD) in order to identify populations suitable for anti-inflammatory treatment. METHODS: This retrospective study included hospitalized patients who underwent coronary angiography between October 2022 and November 2024. The selected participants were grouped by age and sex to compare differences in circulating inflammatory cytokine levels and CAD occurrence. Univariate logistic regression analysis was used to assess the association of cytokines with the incidence of CAD, which was significantly different between age and sex groups. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs). Variables included in the multivariate adjustment model were selected based on their significance as traditional risk factors in the univariate analysis. RESULTS: A total of 2,208 participants (931 women and 1,277 men; 1,270 participants ≥aged 65 years and 938 participants aged <65 years) were included. Circulating interleukin (IL)-1β, IL-2, IL-5, IL-10, and tumor necrosis factor-α levels were significantly different between sexes. Circulating IL-6, IL-8, and IL-12 levels were significantly different between the ≥65-year and <65-year age groups. The fully adjusted model yielded an OR of 1.157 and 95% CI of 1.004-1.334 for CAD occurrence per unit increase in IL-5 in women and an OR of 1.023 and 95% CI of 1.003-1.043 for CAD occurrence per unit increase in IL-6 in older men. CONCLUSION: The independent risk factors for the onset of CAD in women and older men were IL-5 and IL-6, respectively. This finding provides important clues for selecting the appropriate population for anti-inflammatory treatment of CAD. However, due to the retrospective design of this study, there may be unmeasured confounding factors, and future prospective studies are still needed to further verify these associations.