Serum ACE2 activity was higher in young men than young women and showed sex-specific associations with endothelial dysfunction and oxidative stress-related markers, suggesting circulating ACE2 as a potential early biomarker of cardiovascular disease risk in young adults.
Serum ACE2 activity was higher in young men than in young women.
In men, ACE2 activity was positively associated with von Willebrand factor after multiple adjustments.
In men, ACE2 activity was positively associated with ADAMTS13 (a disintegrin-like metalloproteinase with thrombospondin motif type 1 member 13).
In women, ACE2 activity was negatively associated with asymmetric dimethylarginine (ADMA).
In women, ACE2 activity was negatively associated with superoxide dismutase.
The associations between ACE2 activity and endothelial/oxidative stress markers differed by sex.
The authors conclude that circulating ACE2 may serve as a potential early biomarker of cardiovascular disease risk in young adults.
This study looked at an enzyme called ACE2, which is part of the body's blood pressure–regulating system and can be measured in the blood. Researchers measured ACE2 activity in 1134 healthy young adults aged 20-30 (557 men and 577 women) and compared it with blood markers of blood vessel lining health and oxidative stress, a type of cell-damaging chemical imbalance. They found that young men had higher ACE2 activity than young women. The links to other markers differed by sex. In men, higher ACE2 activity went along with higher levels of von Willebrand factor and ADAMTS13, which relate to the integrity of the blood vessel lining and clotting. In women, higher ACE2 activity was linked to lower levels of asymmetric dimethylarginine (a marker of blood vessel dysfunction) and lower superoxide dismutase (an antioxidant enzyme). This research suggests that ACE2 in the blood might reflect early changes in blood vessel health, even in young people without disease, and that these patterns may differ between men and women. Because the study measured everything at one point in time, it cannot show that ACE2 causes these changes or predicts future heart disease; further research would be needed to confirm its usefulness as an early warning marker.
Maugana V, Burrell L, Patel S, Mels C, Schutte A, Mokhaneli M, et al.. (2026). Associations of Angiotensin-Converting Enzyme 2 Activity With Markers of Endothelial Dysfunction and Oxidative Stress in Young Healthy Adults: The African-PREDICT Study.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.047345