Sex Differences in Albumin Quotient and Cerebrospinal Fluid Total Protein Content Do Not Depend on Anthropometric Factors

Abstract

(1) Background: Cerebrospinal fluid (CSF)/serum albumin quotient (QAlb) and CSF total protein (TP) are more elevated in males than females, and this has been hypothesised to be due to anthropometric differences between the sexes. This study aimed to investigate QAlb and CSF TP as a function of body height, weight, and body mass index (BMI). (2) Methods: A total of 207 patients were included in the study and analysed blinded to clinical diagnosis. (3) Results: Multivariable linear regressions were run to predict log-transformed Qalb and log-transformed CSF TP value from age, sex, weight, and height (first model) or from age, sex, and BMI (second model). In both models, age (β = 0.004, 95% CI = 0.002 to 0.006) and sex (β = −0.095, 95% CI = −0.169 to −0.021, and β = −0.135, 95% CI = −0.191 to −0.079) were significant predictors for QAlb, but weight, height, and BMI were not. Similarly, age (β = 0.004, 95% CI = 0.003 to 0.006) and sex (β = −0.077, 95% CI = −0.142 to −0.013, and β = −0.109, 95% CI = −0.157 to −0.060) were significant predictors for CSF TP, while anthropometric characteristics were not. No differences in QAlb and CSF TP were found when grouping males and females by BMI status. (4) Conclusions: Our data suggest that anthropometric characteristics could not explain the sex-related differences in QAlb and CSF TP.

Breaking Barriers: Unveiling Sex-Related Differences in Cerebrospinal Fluid Analysis—A Narrative Review

“…In heavier patients, the accumulation of epidural fat may contribute to a decreased CSF flow rate, leading to an elevation in both the QAlb and total protein concentrations [ 43 ]. In our study, upon examining both males and females collectively, we noted a positive correlation between weight and BMI with QAlb and, to some extent, with protein concentrations in the CSF [ 44 ]. However, this correlation dissipated in sex-stratified analyses and multivariable regressions.…”

“…It is noteworthy that while variables such as age and sex exhibited independent associations with QAlb and total cerebrospinal fluid protein, weight and BMI did not. Consequently, it appears that the disparities in CSF QAlb and TP concentrations between sexes cannot be solely attributed to variances in height, weight or BMI, as the association between sex and these CSF variables persisted even after adjusting for anthropometric factors [ 44 ]. Moreover, the absence of associations between QAlb and CSF protein concentrations with BMI was further confirmed in a multi-comparison analysis in males and females grouped by BMI weight status.…”