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早发型和晚发型阿尔茨海默病痴呆患者临床危险因素的性别差异。

Sex differences in clinical risk factors for Alzheimer's dementia patients with early-onset and late-onset.

作者信息

Faulstich Nathan Gerhard, Hilmi Omar Sammy, John O-Brien Connor, Ojo Dami Taiwo, Brewer Philip Cole, Nathaniel Emmanuel I, Goodwin Richard, Roley Laurie, Imeh-Nathaniel Adebobola, Nathaniel Thomas I

机构信息

University of South Carolina School of Medicine Greenville, Greenville, SC, United States.

Department of Biology, North Greenville University, Tigerville, SC, United States.

出版信息

Front Glob Womens Health. 2025 Aug 4;6:1601375. doi: 10.3389/fgwh.2025.1601375. eCollection 2025.

DOI:10.3389/fgwh.2025.1601375
PMID:40832438
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12358484/
Abstract

BACKGROUND

The objective of this study is to identify the risk factors that contribute to sex differences in patients with Alzheimer dementia (AD), specifically focusing on Early-Onset Alzheimer's Dementia (EAOD) and Late-Onset Alzheimer Dementia (LOAD). Additionally, the study aims to determine whether these risk factors differ between male and female EAOD and LOAD patients.

METHODS

Our retrospective cohort study included a total of 6,212 patients diagnosed with either EOAD or LOAD from February 2016 to August 2020. Among this population, 687 patients (11.06%) were diagnosed with EOAD, while 5,525 patients (88.94%) had LOAD. We conducted a univariate analysis to identify differences in risk factors between male and female AD patients. A multivariate analysis was also performed to predict specific risk factors associated with male and female EOAD and LOAD patients.

RESULTS

In the adjusted analysis, males with LOAD were found to have significantly higher odds of several comorbidities, including dyslipidemia [Odds Ratio (OR) = 1.720, 95% Confidence Interval (CI) = 1.489-1.987,  < 0.001], peripheral vascular disease (OR = 2.324, 95% CI = 1.828-2.955,  < 0.001), obstructive sleep apnea (OR = 2.330, 95% CI = 1.768-3.070,  < 0.001), and pneumonia (OR = 1.235, 95% CI = 1.004-1.520,  = 0.046). In contrast, females with LOAD were associated with lower odds of having hypertension (OR = 0.715, 95% CI = 0.623-0.820,  < 0.001), osteoporosis (OR = 0.310, 95% CI = 0.254-0.380,  < 0.001), urinary tract infections (OR = 0.638, 95% CI = 0.521-0.782,  < 0.001), congestive heart failure (OR = 0.626, 95% CI = 0.481-0.815,  < 0.001), and rheumatoid arthritis. In male patients with EAOD the analysis indicated a strong association with gait dysfunction (OR = 10.797, 95% CI = 3.257-35.792,  < 0.001), peripheral vascular disease (OR = 3.835, 95% CI = 1.767-8.321,  < 0.001), and Chronic Obstructive Pulmonary Disease (COPD) (OR = 5.984, 95% CI = 2.186-16.381,  < 0.001). Conversely, females with EOAD were associated with significantly lower odds of experiencing cerebrovascular accidents (OR = 0.347, 95% CI = 0.155-0.778,  < 0.001), osteoporosis (OR = 0.345, 95% CI = 0.155-0.778,  = 0.030), and anxiety (OR = 0.412, 95% CI = 0.203-0.833,  = 0.014).

CONCLUSIONS

Our findings indicate sex differences in the risk factors for EAOD and LOAD patients. Understanding these risk factors can help us develop strategies to improve diagnostic accuracy, create targeted interventions, and enhance clinical outcomes for both male and female EAOD and LOAD patients.

摘要

背景

本研究的目的是确定导致阿尔茨海默病（AD）患者性别差异的风险因素，特别关注早发性阿尔茨海默病（EAOD）和晚发性阿尔茨海默病（LOAD）。此外，该研究旨在确定这些风险因素在男性和女性EAOD及LOAD患者之间是否存在差异。

方法

我们的回顾性队列研究共纳入了2016年2月至2020年8月期间诊断为EOAD或LOAD的6212例患者。在这一人群中，687例患者（11.06%）被诊断为EOAD，而5525例患者（88.94%）患有LOAD。我们进行了单因素分析，以确定男性和女性AD患者风险因素的差异。还进行了多因素分析，以预测与男性和女性EOAD及LOAD患者相关的特定风险因素。

结果

在调整分析中，发现患有LOAD的男性患几种合并症的几率显著更高，包括血脂异常[比值比（OR）=1.720，95%置信区间（CI）=1.489 - 1.987，P<0.001]、外周血管疾病（OR = 2.324，95% CI = 1.828 - 2.955，P<0.001）、阻塞性睡眠呼吸暂停（OR = 2.330，95% CI = 1.768 - 3.070，P<0.001）和肺炎（OR = 1.235，95% CI = 1.004 - 1.520，P = 0.046）。相比之下，患有LOAD的女性患高血压（OR = 0.715，95% CI = 0.623 - 0.820，P<0.001）、骨质疏松（OR = 0.310，95% CI = 0.254 - 0.380，P<0.001）、尿路感染（OR = 0.638，95% CI = 0.521 - 0.782，P<0.001）、充血性心力衰竭（OR = 0.626，95% CI = 0.481 - 0.815，P<0.001）和类风湿关节炎的几率较低。在患有EAOD的男性患者中，分析表明与步态功能障碍（OR = 10.797，95% CI = 3.257 - 35.792，P<0.001）、外周血管疾病（OR = 3.835，95% CI = 1.767 - 8.321，P<0.001）和慢性阻塞性肺疾病（COPD）（OR = 5.984，95% CI = 2.186 - 16.381，P<0.001）有很强的关联。相反，患有EOAD的女性发生脑血管意外（OR = 0.347，95% CI = 0.155 - 0.778，P<0.001）、骨质疏松（OR = 0.345，95% CI = 0.155 - 0.778，P = 0.030）和焦虑（OR = 0.412，95% CI = 0.203 - 0.833，P = 0.014）的几率显著较低。

结论

我们的研究结果表明EAOD和LOAD患者的风险因素存在性别差异。了解这些风险因素有助于我们制定提高诊断准确性的策略，制定有针对性的干预措施，并改善男性和女性EAOD及LOAD患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/8d7b29151068/fgwh-06-1601375-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/fcf2cf82ceea/fgwh-06-1601375-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/786b5477ceeb/fgwh-06-1601375-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/8d7b29151068/fgwh-06-1601375-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/fcf2cf82ceea/fgwh-06-1601375-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/786b5477ceeb/fgwh-06-1601375-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0330/12358484/8d7b29151068/fgwh-06-1601375-g003.jpg

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