Department of Neurology, Xuan Wu Hospital of the Capital Medical University, Beijing, PR China.
Dement Geriatr Cogn Disord. 2012;33(1):35-42. doi: 10.1159/000336600. Epub 2012 Mar 2.
Studies on the associations between sex hormones and multiple neuropsychiatric symptoms of Alzheimer's disease (AD) are lacking. Apolipoprotein E (APOE) ε4 status may modify the effects of sex hormones on neuropsychiatric symptoms.
A total of 86 male and 87 female AD patients participated in the present study. The adjusted associations between symptoms on the Neuropsychiatric Inventory and serum levels of estradiol (total, bioavailable) and testosterone (total, bioavailable) were analyzed.
Agitation/aggression was negatively associated with quartiles of bioavailable estradiol among male patients, and positively associated with testosterone levels among female patients. The modifying effects of APOE genotype only existed in female patients. Those females with higher levels of estradiol and the ε4 allele had higher odds of agitation/aggression. Furthermore, the testosterone × APOE ε4 status interaction was positively associated with hallucinations in female patients.
There were sex-specific effects of sex hormones on agitation/aggression in AD. Sex hormones and APOE ε4 status synergistically influence some neuropsychiatric symptoms among female but not male AD patients.
关于性激素与阿尔茨海默病（AD）多种神经精神症状之间的关系的研究较少。载脂蛋白 E（APOE）ε4 状态可能会改变性激素对神经精神症状的影响。
本研究共纳入 86 名男性和 87 名女性 AD 患者。分析了神经精神症状问卷上的症状与血清雌二醇（总、生物可用）和睾酮（总、生物可用）水平之间的调整后关联。
在男性患者中，激越/攻击与生物可用雌二醇的四分位间距呈负相关，与女性患者的睾酮水平呈正相关。APOE 基因型的修饰作用仅存在于女性患者中。那些雌二醇和 ε4 等位基因水平较高的女性发生激越/攻击的几率更高。此外，睾酮×APOE ε4 状态相互作用与女性患者的幻觉呈正相关。
性激素对 AD 患者的激越/攻击有性别特异性影响。性激素和 APOE ε4 状态协同影响女性而非男性 AD 患者的一些神经精神症状。
