Fig. 3: Sex-based differences in a subset of KP metabolites and ratios in PD, with more pronounced dysregulation in females.

Interaction plots for a TRP, b 5HT, and c–g KP metabolites and h–j ratios show estimated mean concentrations and 95% CIs for males and females within PD and Control groups after controlling for age in two-way ANCOVA. Sex*PD interaction term was included in all models; significant interactions (P < 0.05) are shown at bottom of respective plots. Asterisks reflect Bonferroni-adjusted P values of post-hoc, pairwise comparisons for simple main effects, with females vs males within PD or Control groups in black and PD vs Control within males or females colored by sex. *P <0.05; **P <0.01, ***P <0.001, ****P <0.0001. Second generation P values also are shown directly above asterisks when significant (Pδ = 0; i.e., the 95% CI of the difference in means did not overlap the specified null interval ( ± 10%)), indicating particularly robust effects. TRP tryptophan, 3HK 3-hydroxykynurenine, QUIN quinolinic acid, KYNA kynurenic acid, KYN kynurenine, PIC picolinic acid, NTA nicotinamide, PD Parkinson’s disease.