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Testosterone, Estradiol, and Sex Hormone-Binding Globulin in Alzheimer’s Disease: A Meta-Analysis

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Background: Previous studies suggested that plasma sex hormones may be implicated in the pathogenesis of Alzheimer’s disease (AD). However, the relationship between sex hormones and AD remains unclear. Objective: To systematically review and quantitatively analyze studies observing plasma total testosterone (TT), estradiol (E2), and sex hormone-binding globulin (SHBG) levels among AD patients. Methods: Medline, EMBASE, the Cochrane Library, and PsycINFO® were searched for studies published prior to March 28th, 2014. Published studies that reported plasma levels of TT, E2, and SHBG in AD and matched controls were included in the present meta-analysis. Results: Meta-analysis was performed using the random effects model, expressing continuous outcomes as the mean difference (MD) between AD and control populations. The 95% confidence intervals (CI) were also calculated. No differences were found in plasma levels of TT and E2 between AD and matched controls (TT MD -0.17 nmol/l, 95%CI -0.54, 0.20; E2 MD -1.16 pmol/l, 95%CI -9.85, 6.83). Plasma levels of SHBG were significantly increased in AD patients compared to healthy controls (SHBG MD 12.94 nmol/l, 95%CI 2.68, 23.20). Conclusion: Patients with AD had higher plasma levels of SHBG. The up-regulated levels of plasma SHBG show preliminary supportive evidence that SHBG and the bioavailability of functional sex hormones in plasma may be linked to the pathogenesis of AD.
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Keywords: Alzheimer’s disease; biomarkers; estradiol; meta-analysis; sex hormone-binding globulin; testosterone

Document Type: Research Article

Publication date: March 1, 2016

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  • Current Alzheimer Research publishes peer-reviewed frontier review and research articles on all areas of Alzheimer's disease. This multidisciplinary journal will help in understanding the neurobiology, genetics, pathogenesis, and treatment strategies of Alzheimer's disease. The journal publishes objective reviews written by experts and leaders actively engaged in research using cellular, molecular, and animal models. The journal also covers original articles on recent research in fast emerging areas of molecular diagnostics, brain imaging, drug development and discovery, and clinical aspects of Alzheimer's disease. Manuscripts are encouraged that relate to the synergistic mechanism of Alzheimer's disease with other dementia and neurodegenerative disorders. Book reviews, meeting reports and letters-to-the-editor are also published. The journal is essential reading for researchers, educators and physicians with interest in age-related dementia and Alzheimer's disease. Current Alzheimer Research provides a comprehensive 'bird's-eye view' of the current state of Alzheimer's research for neuroscientists, clinicians, health science planners, granting, caregivers and families of this devastating disease.
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