阿尔茨海默病中的性别差异 影像化生物标志物在多样化,基于社区的队列中
Muge Akinci1,2, Froogh Aziz1,2, Priya Palta3
1Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.
JAMA network open
|January 27, 2026
概括
女性表现出比男性更大的阿尔茨海默氏症 (AD) 病理和保存的大脑结构. 负担的性别差异在APOE ε4载体中更加明显,突出了AD进展中的性别特异性差异.
科学领域:
- 神经学和神经退行性疾病
- 神经成像和生物标志物
- 阿尔茨海默氏症疾病的发病因子
背景情况:
- 阿尔茨海默病 (AD) 神经病理学的性别差异在各种病理标志物中尚不清楚.
- 之前的研究还没有在代表性的多民族人口中广泛研究这些差异.
- 了解性别特异性AD病理对于有针对性的预防和治疗策略至关重要.
研究的目的:
- 为了研究AD相关病理的神经成像生物标志物的性别差异.
- 分析这些差异在种族和种族多样化的成年人群中.
- 探索性别,年龄,APOE ε4状态和AD病理学上的种族/种族之间的潜在相互作用.
主要方法:
- 在纽约市对503名年龄在60-69岁的认知正常成年人的横截面研究.
- 神经成像包括对粉样蛋白和负荷的PET扫描 (florbetaben,18F-MK-6240) 和对皮质厚度和白质超强度的MRI.
- 使用线性回归分析来评估性别差异,控制人口,APOE ε4和血管因素,并进行FDR校正.
主要成果:
- 与男性相比,女性的全球粉样蛋白负担,布拉克阶段III-VI tau负担和AD标志性皮质厚度显著增加.
- 显著的性别 × APOE ε4相互作用显示,女性携带者比男性携带者更高的布拉克I-IV阶段tau负担.
- 在AD病理标志物上,没有发现性别 × 年龄或性别 × 种族和种族的显著相互作用.
结论:
- 与男性相比,女性表现出更大的阿尔茨海默病病理,但更好地保持了大脑结构完整性.
- 积的性别差异在APOE ε4载体中得到放大,特别是在早期到中期的Braak阶段.
- 这些发现强调了在AD研究和临床实践中将性别视为生物变量的重要性.
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