Apolipoprotein E polymorphisms and severity of cerebral palsy: a cross-sectional study in 255 children in Norway.
Apolipoprotein E polymorphisms and severity of cerebral palsy: a cross-sectional study in 255 children in Norway.
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DOI：
10.1111/dmcn.12086
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发表时间：
2013-04
影响因子：
3.8
通讯作者：
Blackman JA
中科院分区：
文献类型：
--
作者：
Lien E;Andersen GL;Bao Y;Gordish-Dressman H;Skranes JS;Vik T;Blackman JA
本研究的目的是检查载脂蛋白E（ApoE）等位基因APOEε4的存在是否与脑瘫（CP）的严重程度较轻的表现相关，与该等位基因对儿童神经发育的有益作用一致。对255名儿童（141名男性，114名女性;平均年龄12岁，SD 2岁3个月，范围9- 17岁）的颊上皮细胞进行ApoE基因分型，记录在挪威脑瘫登记册中。CP严重程度的主要结局指标是粗大运动功能分类系统（GMFCS）。次要结局指标为精细运动功能、癫痫和胃造口管饲（GTF）的需要。APOEε4基因型与GMFCS水平之间无相关性（比值比[OR] 1.15; 95%可信区间[CI] 0.66-1.99）。然而，APOEε4基因型在癫痫（OR 2.2; 95% CI 1.1-4.2）和/或接受GTF（OR 2.7; 95% CI 1.1-6.6）的儿童中更常见。在单侧CP儿童中，APOEε4的存在与更严重的精细运动障碍相关（OR 2.6; 95% CI 1.3-6.9）。我们关于APOEε4对神经发育有保护作用的主要假设没有得到支持。相反，亚组分析表明APOEε4基因型对损伤后发育中的大脑有不良影响。
The aim of this study was to examine whether the presence of the apolipoprotein E (ApoE) allele APOEε4 is associated with less severe manifestations of cerebral palsy (CP), consistent with the suggested beneficial effect of this allele on neurodevelopment in children. ApoE genotyping was performed on buccal epithelial cells from 255 children (141 males 114 females; mean age 12y, SD 2y 3mo, range 9–17y) recorded in the Cerebral Palsy Register of Norway. The main outcome measure of CP severity was the Gross Motor Function Classification System (GMFCS). Secondary outcome measures were fine motor function, epilepsy, and the need for gastrostomy tube feeding (GTF). There was no association between the APOEε4 genotype and GMFCS levels (odds ratio [OR] 1.15; 95% confidence interval [CI] 0.66–1.99). However, the APOEε4 genotype was more often present among children with epilepsy (OR 2.2; 95% CI 1.1–4.2) and/or receiving GTF (OR 2.7; 95% CI 1.1–6.6). Among children with unilateral CP, the presence of APOEε4 was associated with more severe fine motor impairment (OR 2.6; 95% CI 1.3–6.9). Our main hypothesis that APOEε4 would have a protective effect on neurodevelopment was not supported. Instead, subgroup analyses suggested an adverse effect of the APOEε4 genotype on the developing brain after injury.