Sex differences in CSF biomarkers for neurodegeneration and blood‐brain barrier integrity
Tobias Skillbäck, Kaj Blennow, Henrik Zetterberg, Sara Shams, Alejandra Machado, Joana B. Pereira, Olof Lindberg, Michelle M. Mielke, Anna Zettergren, Lina Rydén, Eric Westman, Lars‐Olof Wahlund, Ingmar Skoog, Silke Kern
Abstract
Abstract Introduction As cerebrospinal fluid (CSF) neurofilament light protein (NfL) and the CSF/serum albumin ratio (Q Alb ) are used in the clinical routine, the impact of demographic factors on these biomarkers is important to understand. Methods Participants were derived from two Swedish samples: the population‐based H70 Study (n = 308, age 70) and a clinical routine cohort (CSF NfL, n = 8995, Q Alb , n = 39252, age 0 to 95). In the population‐based study, Q Alb and NfL were examined in relation to sex, cardiovascular risk factors, and cerebral white matter lesions (WMLs). In the clinical cohort, Q Alb and NfL sex differences were tested in relation to age. Results Men had higher Q Alb and NfL concentrations and had higher Q Alb and NfL concentrations from adolescence throughout life. NfL was not related to WML, but Q Alb correlated positively with WMLs. Discussion The CSF NfL sex difference could not be explained by vascular pathology. Future studies should consider using different reference limits for men and women.