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@ARTICLE{Landstra:279457,
      author       = {Landstra, Elvire-Nadieh and Lohner, Valerie and Breteler,
                      Monique M B},
      title        = {{S}ex-specific relations of ceramides and white matter
                      hyperintensities in the {R}hineland study.},
      journal      = {Scientific reports},
      volume       = {15},
      number       = {1},
      issn         = {2045-2322},
      address      = {[London]},
      publisher    = {Springer Nature},
      reportid     = {DZNE-2025-00784},
      pages        = {23757},
      year         = {2025},
      abstract     = {Women have a higher white matter hyperintensity (WMH)
                      burden compared to men of a similar age, but the causes of
                      this remain unclear. Ceramide (CER) levels differ between
                      men and women and were previously linked to WMH, suggesting
                      they could underlie these sex differences. Therefore, we
                      associated twelve CERs, CER totals, six CER ratios, and a
                      CER score reflecting the CERs most strongly associated with
                      cardiovascular disease, with WMH load in 3,283 participants
                      (30-95 years) of the community-based Rhineland Study. We
                      assessed sex-specific relations between CERs and WMH by
                      including an interaction term and performing sex-stratified
                      analyses. We further investigated the influence of menopause
                      by comparing relations in pre- and postmenopausal women of
                      the same age. Multiple CERs, CER ratios, and the CER score
                      were associated with increased WMH load, with most
                      associations being significantly stronger in women than in
                      men. We found no influence of menopausal status on the
                      associations between CERs and WMH. Thus, we showed novel and
                      strong associations of CERs, CER ratios and the CER score
                      with WMH burden, especially in women. This study suggests
                      that CERs may play an important role in the observed sex
                      differences in WMH burden.},
      keywords     = {Humans / Ceramides: metabolism / Female / Male / Middle
                      Aged / Aged / White Matter: metabolism / White Matter:
                      diagnostic imaging / White Matter: pathology / Adult / Aged,
                      80 and over / Sex Factors / Magnetic Resonance Imaging / Sex
                      Characteristics / Menopause / Brain lipids (Other) /
                      Ceramides (Other) / Epidemiology (Other) / Menopause (Other)
                      / Sex differences (Other) / White matter hyperintensities
                      (Other) / Ceramides (NLM Chemicals)},
      cin          = {AG Breteler},
      ddc          = {600},
      cid          = {I:(DE-2719)1012001},
      pnm          = {354 - Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-354},
      experiment   = {EXP:(DE-2719)Rhineland Study-20190321},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40610590},
      doi          = {10.1038/s41598-025-06911-z},
      url          = {https://pub.dzne.de/record/279457},
}