Middle-Aged Diabetic Females and Males Present Distinct Susceptibility to Alzheimer Disease-like Pathology

E. Candeias, A I Duarte*, I Sebastião, M A Fernandes, A I Plácido, C Carvalho, S Correia, R X Santos, R Seiça, M S Santos, C R Oliveira, P I Moreira*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Type 2 diabetes (T2D) is a highly concerning public health problem of the twenty-first century. Currently, it is estimated that T2D affects 422 million people worldwide with a rapidly increasing prevalence. During the past two decades, T2D has been widely shown to have a major impact in the brain. This, together with the cognitive decline and increased risk for dementia upon T2D, may arise from the complex interaction between normal brain aging and central insulin signaling dysfunction. Among the several features shared between T2D and some neurodegenerative disorders (e.g., Alzheimer disease (AD)), the impairment of insulin signaling may be a key link. However, these may also involve changes in sex hormones' function and metabolism, ultimately contributing to the different susceptibilities between females and males to some pathologies. For example, female sex has been pointed as a risk factor for AD, particularly after menopause. However, less is known on the underlying molecular mechanisms or even if these changes start during middle-age (perimenopause). From the above, we hypothesized that sex differentially affects hormone-mediated intracellular signaling pathways in T2D brain, ultimately modulating the risk for neurodegenerative conditions. We aimed to evaluate sex-associated alterations in estrogen/insulin-like growth factor-1 (IGF-1)/insulin-related signaling, oxidative stress markers, and AD-like hallmarks in middle-aged control and T2D rat brain cortices. We used brain cortices homogenates obtained from middle-aged (8-month-old) control Wistar and non-obese, spontaneously T2D Goto-Kakizaki (GK) male and female rats. Peripheral characterization of the animal models was done by standard biochemical analyses of blood, plasma, or serum. Steroid sex hormones, oxidative stress markers, and AD-like hallmarks were given by specific ELISA kits and colorimetric techniques, whereas the levels of intracellular signaling proteins were determined by Western blotting. Albeit the high levels of plasma estradiol and progesterone observed in middle-aged control females suggested that they were still under their reproductive phase, some gonadal dysfunction might be already occurring in T2D ones, hence, anticipating their menopause. Moreover, the higher blood and lower brain cholesterol levels in female rats suggested that its dysfunctional uptake into the brain cortex may also hamper peripheral estrogen uptake and/or its local brain steroidogenic metabolism. Despite the massive drop in IGF-1 levels in females' brains, particularly upon T2D, they might have developed some compensatory mechanisms towards the maintenance of estrogen, IGF-1, and insulin receptors function and of the subsequent Akt- and ERK1/2-mediated signaling. These may ultimately delay the deleterious AD-like brain changes (including oxidative damage to lipids and DNA, amyloidogenic processing of amyloid precursor protein and increased tau protein phosphorylation) associated with T2D and/or age (reproductive senescence) in female rats. By demonstrating that differential sex steroid hormone profiles/action may play a pivotal role in brain over T2D progression, the present study reinforces the need to establish sex-specific preventive and/or therapeutic approaches and an appropriate time window for the efficient treatment against T2D and AD.

Original languageEnglish
Pages (from-to)6471-6489
Number of pages19
JournalMolecular Neurobiology
Issue number8
Early online date11 Oct 2016
Publication statusPublished - Oct 2017

Bibliographical note

We are grateful to Doctor Paula Agostinho and Professor Rodrigo Cunha (CNC.IBILI Consortium, University of Coimbra, Coimbra, Portugal) for kindly providing us the antibodies anti-Cdk5 and -p35/25, and to Professor Jorge Oliveira (Faculty of Pharmacy, University of Porto, Porto, Portugal) for his valuable tips with statistical analysis. This work was funded by European funds from FEDER, through the Programa Operacional Factores de Competitividade – COMPETE 2020; by Portuguese funds from FCT - Fundação para a Ciência e a Tecnologia (PTDC/SAU-TOX/117481/2010, PTDC/SAU-NMC/110990/2009, PTDC/SAU-NEU/103325/2008 and Strategic Project UID/NEU/04539/2013); by Programa de Estímulo à Investigação, Faculty of Medicine, University of Coimbra, Portugal (PMADSC/2011), and by European Social Fund: Fellowships SFRH/BD/90036/2012 to E. Candeias; SFRH/BPD/84473/2012 to A. I. Duarte).


  • sex
  • type 2 diabetes
  • alzheimer disease-like hallmarks
  • insulin
  • sex steroids


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