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However, its potential connection to Alzheimer's disease (AD) pathology in humans remains largely unexplored. This cross\u2010section study included 238 cognitively unimpaired participants, 26 mild cognitive impairment (MCI) patients, 54 AD dementia patients, and 32 patients with non\u2010AD neurodegenerative diseases. Plasma and cerebrospinal fluid (CSF) levels of OCN were measured by enzyme\u2010linked immunosorbent assay kits. In the clinical diagnosis\u2010based subgroup, plasma and CSF levels of OCN were significantly higher in MCI and AD dementia compared with cognitively unimpaired participants. In the ATN framework\u2010based subgroup, plasma and CSF OCN levels were significantly elevated in A\u03b2\u2010positive participants, including those in the preclinical stage of AD. Both plasma and CSF OCN levels were negatively correlated with CSF A\u03b242 and positively correlated with CSF total\u2010tau and phosphorylated\u2010tau181\/A\u03b242. In addition, OCN mediated the relationship between A\u03b2 pathology and tau pathology. Notably, OCN levels in plasm and CSF were also negatively associated with cognitive functions. This study provides clinical evidence linking OCN to AD, suggesting that OCN may be associated with brain A\u03b2 deposition, tau hyperphosphorylation and neurodegeneration.<\/jats:p>","DOI":"10.1002\/mco2.70255","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T02:40:33Z","timestamp":1750387233000},"source":"Crossref","is-referenced-by-count":11,"title":["Associations of Plasma and CSF Osteocalcin Levels With CSF ATN Biomarkers and Cognitive Functions in Alzheimer's Disease"],"prefix":"10.1002","volume":"6","author":[{"given":"Xian\u2010Le","family":"Bu","sequence":"first","affiliation":[{"name":"Department of Neurology and Centre for Clinical Neuroscience Daping Hospital Third Military Medical University  Chongqing China"},{"name":"Chongqing Key Laboratory of Ageing and Brain Diseases  Chongqing China"},{"name":"Institute of Brain and Intelligence Third Military Medical University  Chongqing China"},{"name":"State Key Laboratory of Trauma and 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