ツチヤ　ケン   Tsuchiya Ken   土谷　健    所属   医学部 医学科（東京女子医科大学病院）    職種   特任教授
言語種別	英語
発表タイトル	Sex- and Age-Related Variations in Intracranial Aneurysms among Patients with ADPKD: Significance of Middle Cerebral Artery Aneurysms in Elderly Women
会議名	Kidney Week 2024
主催者	American Society of Nephrology
学会区分	国際学会及び海外の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎Ushio Yusuke, Kataoka Hiroshi, Mochizuki Toshio, Manabe Shun, Seki Momoko, Tsuchiya Ken, Nitta Kosaku, Hoshino Junichi,
発表年月日	2024/10/26
国名	アメリカ合衆国
開催地 （都市, 国名）	San Diego, USA
開催期間	2024/10/24～2024/10/27
概要	Background The effects of sex differences on intracranial aneurysms (IAs) in patients with autosomal dominant polycystic kidney disease (ADPKD) are not fully elucidated. Methods We enrolled 519 patients with ADPKD. Logistic regression analyses using sex, age ≥50 years, hypertension, family history of IA or subarachnoid hemorrhage (IA/SAH), and chronic kidney disease (CKD) stages 4–5 or height-adjusted total kidney volume (htTKV) were conducted to identify factors related to IAs. Results Sex disparities in intracranial aneurysms (IAs) were evident among ADPKD patients. Women showed a higher prevalence of anterior circulation IAs compared to men (62.7% vs. 44.8%; P=0.0403), with women also experiencing SAH at an older age than men (46 years vs. 37.5 years; P=0.0490). In the entire cohort, female sex was significantly linked with IA (OR=1.78). Stratified by sex, CKD stages 4–5 (OR=4.21), family history of IA/SAH (OR=3.11), and hypertension (OR=2.22) were significantly associated with IA in females, while in males, only family history of IA/SAH (OR=2.35) and CKD stages 4–5 (OR=2.21) were risk factors for IA. Interestingly, when classified by sex and age (≥50 years), gender disparities in IAs were pronounced among patients aged ≥50 years. Anterior circulation IAs (OR=4.58: 71.4% in women vs. 35.3% in men; P=0.0173), particularly middle cerebral artery IAs (OR=10.88: 40.5% in women vs. 5.9% in men; P=0.0113), were more prevalent in women aged ≥50 years compared to men. Moreover, women aged ≥50 years had a significantly higher prevalence of hypertension (OR=4.11), CKD4–5 (OR=10.60), IAs (OR=3.06), and middle cerebral artery IAs (OR=5.93) compared to those <50 years. Additionally, women over 50 years exhibited an increased incidence of middle cerebral artery aneurysms, with multivariate logistic analysis associating these aneurysms with female gender and hypertension. Conclusion IAs in patients with ADPKD were affected by attributes (age and sex). Sex and age-specific medical treatment might be desirable, especially, women should pay attention to the incidence of middle aortic aneurysm and its risk factors, which increase with age.