METHODS: In the Tobago Health Study (n = 309; 109 women, mean age 70.3 ± 6.6), we assessed sex differences and risk factors for serum levels of phosphorylated tau-181 (p-tau181), amyloid-beta (Aβ)42/40 ratio, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Blood samples were from 2010 to 2013 for men and from 2019 to 2023 for women.
RESULTS: Women were more obese, hypertensive, and sedentary but reported less smoking and alcohol use than men (age-adjusted p < 0.04). Compared to men, women had worse levels of AD biomarkers, with higher p-tau181 and lower Aβ42/40, independent of covariates (p < 0.001). In sex-stratified analyses, higher p-tau181 was associated with older age in women and with hypertension in men. GFAP and NfL did not differ by sex.
CONCLUSIONS: Women had worse AD biomarkers than men, unexplained by age, cardiometabolic diseases, or lifestyle. Studying risk factors for AD in PAA is warranted, especially for women earlier in life.
方法:在Tobago健康研究中(n=309;109名妇女,平均年龄70.3±6.6),我们评估了血清磷酸化tau-181(p-tau181)水平的性别差异和危险因素,淀粉样β(Aβ)42/40比例,胶质纤维酸性蛋白(GFAP),和神经丝轻链(NfL)。男性的血液样本为2010年至2013年,女性的血液样本为2019年至2023年。
结果:女性更肥胖,高血压,久坐不动,但报告吸烟和饮酒少于男性(年龄调整后p<0.04)。和男人相比,女性的AD生物标志物水平更差,p-tau181较高,Aβ42/40较低,与协变量无关(p<0.001)。在性别分层分析中,较高的p-tau181与女性年龄和男性高血压相关.GFAP和NfL没有性别差异。
结论:女性的AD生物标志物比男性差,无法解释的年龄,心脏代谢疾病,或生活方式。有必要研究PAA中AD的危险因素,尤其是对生命早期的女性来说。