Background The importance of cerebrospinal fluid (CSF) diagnostics for psychiatry is growing. The CSF/blood albumin quotient (Q Alb ) is considered to be a measure of the blood–CSF barrier function. Recently, systematically higher Q Alb in males than in females was described in neurological patients. The aim of this study was to investigate whether a sex difference could also be detected in a well-characterized psychiatric cohort. Methods The patient cohort comprised 989 patients, including 545 females and 444 males with schizophreniform and affective syndromes who underwent CSF diagnostics, including Q Alb measurement. The basic CSF findings and antineuronal autoantibody data of this cohort have already been published. This re-analysis employed analysis of covariance with age correction for Q Alb mean values and chi 2 -testing for the number of increased age-corrected Q Alb levels to investigate sex differences in Q Alb . Results The Q Alb levels were elevated above reference levels by 18% across all patients, and a comparison between male and female patients revealed a statistically significant sex difference, with increased values in 26% of male patients and a corresponding rate of only 10% in female patients ( chi 2 = 42.625, p < 0.001). The mean Q Alb values were also significantly higher in males (6.52 ± 3.69 × 10 –3 ) than in females (5.23 ± 2.56 × 10 –3 ; F = 52.837, p < 0.001). Discussion The main finding of this study was a significantly higher Q Alb level in male compared to female patients with psychiatric disorders, complementing previously described sex differences in neurological patient cohorts. This result indicates bias from some general factors associated with sex and could be partly explained by sex differences in body height, which is associated with spine length and thus a longer distance for CSF flow within the subarachnoid space down the spine from the occipital area to the lumbar puncture site in males compared to females. Hormonal influences caused by different estrogen levels and other sex-specific factors could also play a relevant role. The significance of the study is limited by its retrospective design, absence of a healthy control group, and unavailability of exact measures of spine length.

中文翻译：

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精神分裂症和情感性精神病患者脑脊液/血白蛋白商的性别差异


背景 脑脊液 (CSF) 诊断对于精神病学的重要性日益增加。脑脊液/血白蛋白商 (Q Alb ) 被认为是血脑脊液屏障功能的衡量标准。最近，在神经系统患者中，男性的 Q Alb 系统性地高于女性。本研究的目的是调查是否也可以在特征明确的精神病学队列中检测到性别差异。方法 患者队列由 989 名患有精神分裂症和情感综合征的患者组成，其中包括 545 名女性和 444 名男性，他们接受了 CSF 诊断，包括 Q Alb 测量。该队列的基本脑脊液研究结果和抗神经元自身抗体数据已经发表。该重新分析采用了 Q Alb 平均值的年龄校正协方差分析和年龄校正 Q Alb 水平增加数量的卡方检验，以调查 Q Alb 的性别差异。结果 所有患者的 Q Alb 水平均高于参考水平 18%，男性和女性患者之间的比较显示出统计学上显着的性别差异，男性患者中 26% 的 Q Alb 水平升高，而女性患者的相应比例仅为 10%。女性患者（chi 2 = 42.625，p < 0.001）。男性的平均 Q Alb 值 (6.52 ± 3.69 × 10 –3 ) 也显着高于女性 (5.23 ± 2.56 × 10 –3 ；F = 52.837，p < 0.001)。讨论 本研究的主要发现是，与女性精神疾病患者相比，男性的 Q Alb 水平显着较高，补充了之前描述的神经系统患者队列中的性别差异。 这一结果表明，一些与性别相关的一般因素存在偏差，部分原因是身高的性别差异，身高与脊柱长度有关，因此脑脊液在蛛网膜下腔内从枕骨区域向下流到脊柱的距离更长。男性与女性腰椎穿刺部位的比较。不同雌激素水平和其他性别特异性因素引起的荷尔蒙影响也可能发挥相关作用。这项研究的意义受到其回顾性设计、缺乏健康对照组以及无法精确测量脊柱长度的限制。