阿尔茨海默病进展中的性别特异性生物标志物：弗雷明汉心脏研究。
Sex-specific biomarkers in Alzheimer's disease progression: Framingham Heart Study.
作者信息
Liu Chunyu, Li Yi, Nwosu Adaora, Ang Ting Fang Alvin, Liu Yulin, Devine Sherral, Au Rhoda, Doraiswamy P Murali
机构信息
Department of Biostatistics Boston University School of Public Health Boston Massachusetts USA.
Framingham Heart Study Boston University School of Medicine Boston Massachusetts USA.
出版信息
Alzheimers Dement (Amst). 2022 Nov 3;14(1):e12369. doi: 10.1002/dad2.12369. eCollection 2022.
BACKGROUND
Sex differences in Alzheimer's disease (AD) are not well understood.
METHODS
We performed sex-specific analyses of AD and annualized cognitive decline with clinical and blood biomarker data in participants 60+ years old in the community-based longitudinal Framingham Heart Study Offspring Cohort ( = 1398, mean age 68 years, 55% women).
RESULTS
During 11 years of follow-up, women were 96% more likely than men to be diagnosed with clinical AD dementia after adjusting for age and education in the younger age group 60 to 70 years ( = 946; 95% confidence interval [CI], 1.08 to 3.56) although not in the older age group (70+) ( = 452; hazard ratio = 0.98; 95% CI, 0.68 to 1.53). Sex-differences in incident AD rates decreased with increasing levels of education. The total contribution of the biomarkers to AD risk variance was 7.6% in women and 11.7% in men. One unit (pg/ml) lower plasma Aβ42 was associated with 0.0095 unit faster memory decline in women ( = 0.0002) but not in men ( = 0.55) after adjusting for age and education.
DISCUSSION
Our study suggests that both early life and later-life pathological factors may contribute to potential sex differences in incident AD.
背景
阿尔茨海默病（AD）中的性别差异尚未得到充分理解。
方法
我们在基于社区的纵向弗明汉心脏研究后代队列中，对60岁及以上参与者（n = 1398，平均年龄68岁，55%为女性）的AD及年化认知衰退进行了性别特异性分析，并结合临床和血液生物标志物数据。
结果
在11年的随访期间，在60至70岁的较年轻年龄组中，调整年龄和教育因素后，女性被诊断为临床AD痴呆的可能性比男性高96%（n = 946；95%置信区间[CI]，1.08至3.56），而在70岁及以上的较年长年龄组中则不然（n = 452；风险比 = 0.98；95% CI，0.68至1.53）。AD发病率的性别差异随着教育水平的提高而减小。生物标志物对AD风险方差的总贡献率在女性中为7.6%，在男性中为11.7%。调整年龄和教育因素后，血浆Aβ42每降低1个单位（pg/ml），女性的记忆衰退速度加快0.0095个单位（p = 0.0002），而男性则不然（p = 0.55）。
讨论
我们的研究表明，早期生活和后期生活的病理因素可能都导致了AD发病率潜在的性别差异。
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