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Distinctive effect of biological sex in AD‐related CSF and plasma biomarkers
Author(s) -
MilàAlomà Marta,
Brinkmalm Ann,
Rodriguez Juan Lantero,
Karikari Thomas K.,
Ashton Nicholas J.,
Kvartsberg Hlin,
GrauRivera Oriol,
SalaVila Aleix,
SánchezBenavides Gonzalo,
ArenazaUrquijo Eider M.,
BrugulatSerrat Anna,
Akinci Muge,
GonzálezdeEchávarri José Maria,
Minguillón Carolina,
Fauria Karine,
Suridjan Ivonne,
Kollmorgen Gwendlyn,
Stoops Erik,
Vanmechelen Eugeen,
Zetterberg Henrik,
Blennow Kaj,
Molinuevo Jose,
SuarezCalvet Marc
Publication year - 2021
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.052959
Subject(s) - neurogranin , medicine , biomarker , cerebrospinal fluid , cohort , oncology , body mass index , logistic regression , endocrinology , gastroenterology , biology , biochemistry , protein kinase c , enzyme
Abstract Background Clinical studies indicate that Alzheimer's disease (AD) disproportionately affects women. Although previous studies reported sex differences in fluid biomarkers, there is a need for a comprehensive analysis across the disease continuum . The aim of this study was to compare AD‐related biomarkers in cerebrospinal fluid (CSF) and plasma between women and men in middle‐aged cognitively‐unimpaired individuals at risk for AD. Method We measured Aβ42, Aβ40, Mid (M)‐p‐tau 181, N‐terminal (N)‐p‐tau 181, N‐p‐tau 217, M‐p‐tau 231, t‐tau, NfL, neurogranin, SNAP25, GAP43, synaptotagmin1, sTREM2, YKL40, GFAp, S100B, IL6, sVCAM1, sICAM1, MCP1 and α‐synuclein in CSF; and N‐p‐tau181, NfL, GFAp, MCP1, sICAM1 and sVCAM1 in plasma. Biomarker measurements were performed using immunoassays (colorimetric, MSD, Elecsys®, Simoa and the exploratory Roche NeuroToolKit robust prototype assays) and mass spectrometry. We tested sex differences in demographic variables (using t ‐test or Chi‐squared) and in cardiovascular factors (using ANCOVA adjusted for age and APOE‐ε4 status). Sex differences in biomarkers were assessed with 3 different ANCOVA models, adjusted for (i) age, (ii) age and CSF Aβ42/40 and (iii) age and cardiovascular factors that showed sexual divergence. Result We studied 384 participants of the ALFA+ cohort. Men had higher education, APOE‐ε4 prevalence, physical activity, diastolic blood pressure, BMI, glucose and triglycerides than women. In contrast, women had higher vitamin B12, LDL, HDL and total cholesterol as compared to men. In CSF (Table 1), men had higher NfL, GFAp, MCP1, sICAM1 and sVCAM1, while women had higher neurogranin, synaptotagmin‐1 and N‐p‐tau 217, after adjusting for age (Model I). These differences remained significant after adjusting for CSF Aβ42/40 (Model II). In plasma (Table 2), we observed an opposite pattern compared to results in CSF: women showed higher NfL, GFAp and sICAM1 after adjusting for age (Model I) and for CSF Aβ42/40 (Model II). Sex differences in CSF NfL, sICAM1, sVCAM1, and plasma sICAM1 remained significant after adjustingg for cardiovascular factors (Model III). Conclusion AD‐related fluid biomarkers of neurodegeneration and neuroinflammation/endothelial dysfunction differ between women and men, but these differences have an opposite direction for some biomarkers in CSF and plasma. These results highlight the importance of considering sex differences in AD‐related fluid biomarkers.