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Sex differences in CSF biomarkers for neurodegeneration and blood‐brain barrier integrity
Author(s) -
Skillback Tobias,
Blennow Kaj,
Zetterberg Henrik,
Shams Sara,
Machado Alejandra,
Pereira Joana B.,
Lindberg Olof,
Mielke Michelle M.,
Zettergren Anna,
Rydén Lina,
Westman Eric,
Wahlund LarsOlof,
Skoog Ingmar,
Kern Silke
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.038588
Subject(s) - cohort , biomarker , medicine , population , cohort study , white matter , physiology , biology , magnetic resonance imaging , biochemistry , environmental health , radiology
Abstract Background CSF neurofilament light protein (NfL) is an important biomarker in several neurologic diseases. CSF NfL concentrations are known to increase with age, but sex differences have been less examined. The CSF/serum albumin ratio (Q Alb ) is a biomarker for blood‐brain barrier integrity, which has previously been found to be higher in men. As NfL and Q Alb are used in clinical routine, the impact of demographic factors on these biomarkers is important to understand. Method Participants were derived from two samples. The first was a population‐based cohort of 308 70‐year olds from the Gothenburg H70 Birth Cohort Study, Sweden. The second data set comprised CSF NfL and Q Alb results from 8995 and 39252 subjects respectively, generated in clinical practice between 2005‐2012 in Gothenburg, Sweden. In the population‐based study, Q Alb and NfL concentrations were examined in relation to sex, cardiovascular risk factors, and MRI signs of cerebral white matter lesions. In the clinical routine cohort, sex differences in Q Alb and NfL were tested in relation to age. Result In the population‐based sample, men had higher Q Alb and NfL concentrations than women. NfL was not related to cerebral vascular pathology, but Q Alb correlated positively with several measures of white matter lesions. In the clinical routine cohort, men also had higher Q Alb and NfL concentrations from adolescence and throughout life. Conclusion Q Alb ratios and CSF NfL levels are higher in men throughout life. The CSF NfL sex difference could not be explained by vascular pathology. Future studies should consider using different reference limits for men and women.

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