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. 2021 May 13;10:e63425. doi: 10.7554/eLife.63425

Table 1. Sex specificity in human biological aging and associated theories.

Human biomarker of aging Sex-specific effects References Aging theories Sexual dimorphism theories
 Genetic factors in aging Sex chromosomes,
X-chromosome inactivation in women,
Loss of Y in men,
Common genetic variants for anthropometric traits,
Transcriptional regulation
Bernabeu, 2020; Forsberg, 2017; Gentilini et al., 2012; Randall et al., 2013 Senescence theory of aging:
1. Disposable soma
2. Mutation accumulation
Programmed theory of aging:
1. Developmental processes and growth
Sex chromosomes
Hormones
 Mitochondria-linked mechanisms Better respiratory function in women,
Mutation accumulation,
Higher mtDNA abundance in women
Hägg et al., 2020; Demarest and McCarthy, 2015; Ventura-Clapier et al., 2017 Senescence theory of aging:
1. ROS theory of aging
2. Mutation accumulation
Hormones
 Cellular senescence More senescent cells in male mice compared to females. Yousefzadeh et al., 2020 Senescence theory of aging Unknown
 Proteostasis and autophagy Higher proteasomal activity in female mice and flies Jenkins et al., 2020; Pomatto et al., 2017 Senescence theory of aging:
1. ROS theory of aging
Unknown
 Telomeres Longer telomeres in girls/women Factor-Litvak et al., 2016; Gardner et al., 2014 Programmed theory of aging:
1. Hayflick limit
2. Developmental processes and growth
Senescence theory of aging:
1. ROS theory of aging
Sex chromosomes,
Hormones
 Epigenetics Higher epigenetic age in boys/men,
Genome-wide DNA methylation and histone differences
Horvath et al., 2016; Horvath and Raj, 2018; Klein et al., 2019 Programmed theory of aging:
1. Hayflick limit
2. Developmental processes and growth
Senescence theory of aging:
1. Disposable soma
2. Mutation accumulation
Sex chromosomes,
Hormones
 Inflammatory and immunological markers Men more affected by immunosenescence and inflammaging Gubbels Bupp, 2015; Gomez et al., 2018; Franceschi, 2019 Senescence theory of aging:
1. ROS theory of aging
Hormones
 Nutrient sensing and metabolism Women have more beneficial (lower) fasting insulin levels Templeman and Murphy, 2018; Pignatti et al., 2020; Comitato et al., 2015 Senescence theory of aging:
1. The rate of living theory
Programmed theory of aging
Hormones
 Functional measures Men perform better in physical functioning, regardless of the measures Peiffer et al., 2010; Ganna and Ingelsson, 2015; Frederiksen et al., 2006; Finkel et al., 2019 Senescence theory of aging:
1. ROS theory of aging
2. The rate of living theory
Hormones
 Frailty Women have higher levels, but men are more vulnerable to death at any given level Gordon et al., 2017; Gordon and Hubbard, 2019 Senescence theory of aging:
1. Disposable soma
Hormones
Leading causes of death (noncommunicable diseases) worldwide in 70 + year olds:
1. Ischemic heart disease
2. Stroke
3. Chronic obstructive pulmonary disease
4. Alzheimer's disease and other dementias
5. Diabetes mellitus
6. Trachea, bronchus, lung cancers
7. Kidney diseases
8. Hypertensive heart disease
9. Colon and rectum cancers
Men have higher incidence and death rates in:
1. Ischemic heart disease
5. Diabetes mellitus in midlife
6. Trachea, bronchus, and lung cancers
9. Colon and rectum cancers
Men have higher incidence of:
2. Stroke in early adulthood
5. Diabetes mellitus in midlife
Women have higher incidence and death rates in:
2. Stroke in late life
3. Chronic obstructive pulmonary disease
4. Alzheimer's disease and other dementias
7. Kidney diseases
8. Hypertensive heart disease
Women have higher incidence of:
5. Diabetes mellitus in youth
World Health Organization, 2021; Mauvais-Jarvis et al., 2020 Programmed theory of aging
Senescence theory of aging
Hormones,
Sex chromosomes