Effect of Alzheimer disease genetic risk disclosure on dietary supplement use
Effect of Alzheimer disease genetic risk disclosure on dietary supplement use
复制标题
DOI：
10.3945/ajcn.2009.28981
复制
发表时间：
2010-05-01
影响因子：
7.1
通讯作者：
Green, Robert C.
中科院分区：
文献类型：
--
作者：
Vernarelli, Jacqueline A.;Roberts, J. Scott;Green, Robert C.
背景：APOE基因披露的阿尔茨海默病(AD)遗传易感性检测不推荐用于临床，但可通过直接面向消费者(DTC)的基因检测公司获得。目前尚不清楚APOE基因披露是否真的会促使高危个体的营养行为发生改变。目的：我们研究了APOE基因披露对有AD家族史的成年人饮食补充剂使用的影响。设计：作为对第二次AD风险评估和阿尔茨海默病教育研究数据的二次分析的一部分，我们检查了272名AD患者未受影响的一级亲属的基因披露对健康行为变化的影响。结果：总体而言，16%的参与者报告在AD风险评估后饮食补充剂的使用发生了变化。在对年龄、性别、种族、补充剂使用基线、随机化和教育水平进行调整后，了解到他们至少有一个风险增加的epsilon 4等位基因(epsilon 4+)的参与者报告饮食补充剂使用发生变化的几率是那些没有风险增加epsilon 4等位基因(epsilon 4-)的参与者的4.75倍(95%CI：2.23，10.10；P<；0.0001)。APOE epsilon 4+和epsilon 4-参与者在总体饮食、运动或药物方面的变化没有显著差异。结论：在接受AD遗传易感性测试的一级亲属样本中，APOE epsilon 4+基因状态与风险披露后膳食补充剂的使用呈正相关。尽管没有证据表明服用补充剂可以降低AD的风险，但这些变化还是发生了。鉴于DTC基因测试的扩展，这项研究强调了未来在疾病风险沟通方面研究的必要性。AM J Clin Nutr 2010；91：1402-7。
Background: Genetic susceptibility testing for Alzheimer disease (AD) with APOE genotype disclosure is not recommended for clinical use but is available through direct-to-consumer (DTC) genetic testing companies. Little is known about whether APOE genotype disclosure would actually prompt changes in nutrition behaviors among at-risk individuals.Objective: We studied the effect of APOE genotype disclosure for AD risk assessment on dietary supplement use in adults with a family history of AD.Design: As part of a secondary analysis of data from the second Risk Evaluation and Education for Alzheimer's Disease Study, we examined the effect of genotype disclosure on health-behavior changes among 272 unaffected first-degree relatives of persons with AD.Results: Overall, 16% of all participants reported a change in dietary supplement use after AD risk assessment. Participants who learned that they had at least one copy of the risk-increasing epsilon 4 allele (epsilon 4+) had 4.75 times the odds of reporting a change in dietary supplement use than did their counterparts who had an absence of the risk-increasing epsilon 4 allele (epsilon 4-) (95% CI: 2.23, 10.10; P < 0.0001) after adjustment for age, sex, race, baseline supplement use, randomization arm, and educational level. There were no significant differences between APOE epsilon 4+ and epsilon 4- participants in changes in overall diet, exercise, or medications.Conclusions: In this sample of first-degree relatives receiving genetic susceptibility testing for AD, an APOE epsilon 4+ genotype status was positively associated with dietary supplement use after risk disclosure. Such changes occurred despite the absence of evidence that supplement use reduces the risk of AD. Given the expansion of DTC genetic tests, this study highlights the need for future studies in disease risk communication. Am J Clin Nutr 2010;91:1402-7.