CE(20:4) and CE(22:5) cholesteryl ester levels are elevated in the plasma of Alzheimer’s disease patients with ε3/ε4 genotype

Eleonora Stefanini , Joan Serrano-Marín , Alberto Iglesias , Miguel G. Fernández , Juan Sánchez-Navés , Hanan A. Alkozi , David Bernal-Casas , Rafael Franco

Exploration of Neuroprotective Therapy ›› 2025, Vol. 5 ›› Issue (1) : 100497

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Exploration of Neuroprotective Therapy ›› 2025, Vol. 5 ›› Issue (1) :100497 DOI: 10.37349/ent.2025.100497
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CE(20:4) and CE(22:5) cholesteryl ester levels are elevated in the plasma of Alzheimer’s disease patients with ε3/ε4 genotype
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Abstract

Aim:This study investigates the association between ApoE genotype, plasma cholesteryl ester (CE) levels, and Alzheimer’s disease (AD) status, with a focus on CE(20:4) and CE(22:5) levels as potential indicators of lipid metabolism alterations in AD patients.
Methods:Publicly available metabolomics data (DOI: 10.3233/JAD-215448) from 94 AD patients and 62 controls aged 55 and older were re-analyzed. CE levels were examined using non-parametric tests due to the non-normal overall data distribution. Comparisons were stratified by ApoE genotypes (ε3/ε3 and ε3/ε4).
Results:Significant increases in CE(20:4) and CE(22:5) levels were observed in AD patients with the ApoE ε3/ε4 genotype compared to controls (p-values 0.0387 and 0.0348, respectively). No significant differences were found for other CEs or among ε3/ε3 carriers (except for sex). Overlap between CE levels in AD and control groups limits their potential as diagnostic biomarkers but underscores their role in lipid dysregulation in AD pathophysiology.
Conclusions:Elevated CE(20:4) and CE(22:5) levels in ε3/ε4 AD patients highlight lipid metabolism alterations associated with ApoE genotype. While not providing standalone biomarkers, these findings offer insights into AD-related lipid dysregulation and warrant further investigation in high-risk ε4/ε4 carriers and therapeutic targeting of lipid metabolism.

Keywords

Metabolomics / biomarker / neurodegenerative diseases / cohort / cholesterol metabolism / cholesteryl esters / lipoproteins / lipidomics

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Eleonora Stefanini, Joan Serrano-Marín, Alberto Iglesias, Miguel G. Fernández, Juan Sánchez-Navés, Hanan A. Alkozi, David Bernal-Casas, Rafael Franco. CE(20:4) and CE(22:5) cholesteryl ester levels are elevated in the plasma of Alzheimer’s disease patients with ε3/ε4 genotype. Exploration of Neuroprotective Therapy, 2025, 5 (1) : 100497 DOI:10.37349/ent.2025.100497

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