Genetic regulation of the metabolome differs by sex, Alzheimer's disease stage, and plasma biomarker status

Alzheimers Dement. 2025 Nov;21(11):e70898. doi: 10.1002/alz.70898.

Abstract

Introduction: We investigated genetic regulators of circulating plasma metabolites to identify pathways underlying biochemical changes in clinical and biomarker-supported Alzheimer's disease (AD).

Methods: We computed metabolite quantitative trait loci (QTL) with whole-genome sequencing (WGS) and small molecule plasma metabolites from 229 older adults with clinical AD and 322 age-matched healthy controls. Unbiased associations between 6881 metabolites and 332,772 common genetic variants were tested, adjusted for age, sex, and both metabolomic and genomic principal components.

Results: We identified 72 SNP-metabolite associations spanning 66 genes and 12 metabolite classes, including PYROXD2/N6-methyllysine, FAAH/myristoylglycine, and FADS2/arachidonic acid. Additionally, we found differences in genetic regulation of metabolites among individuals with clinically-defined AD compared to biomarker-defined AD based on a published plasma P-tau181 cutoff. We also found more SNP-metabolite associations among males compared to females.

Discussion: In summary, we identified sex- and disease-specific genetic regulators of plasma metabolites, revealing unique biological mechanisms of genetic perturbations in AD.

Highlights: Genetic regulators of the metabolome spanned 66 genes and 12 metabolite classes. Clinically versus biomarker-defined Alzheimer's disease (AD) affects genetic regulators of the metabolome. Most metabolite quantitative trait loci (QTLs) are not shared between males and females.

Keywords: Alzheimer's disease; genetic regulation; genomics; metabolites; metabolomics; quantitative trait loci.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / blood
  • Alzheimer Disease* / genetics
  • Alzheimer Disease* / metabolism
  • Biomarkers / blood
  • Female
  • Humans
  • Male
  • Metabolome* / genetics
  • Polymorphism, Single Nucleotide / genetics
  • Quantitative Trait Loci / genetics
  • Sex Factors

Substances

  • Biomarkers