Incidence of Alzheimer disease in a biracial urban community - Relation to apolipoprotein E allele status
Incidence of Alzheimer disease in a biracial urban community - Relation to apolipoprotein E allele status
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DOI：
10.1001/archneur.60.2.185
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发表时间：
2003-02-01
影响因子：
--
通讯作者：
Schneider, J
中科院分区：
文献类型：
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作者：
Evans, DA;Bennett, DA;Schneider, J
背景：很少有研究比较阿尔茨海默病(AD)在黑人和白人受试者中的发病率。目的：估计阿尔茨海默病(AD)在这些种族中的发病率和载脂蛋白E(APOE)是4个等位基因的元素的影响。设计：使用随机、分层样本进行基于人群的疾病发病率研究。背景：在伊利诺伊州芝加哥，一个地理上定义的由3个邻近社区组成的社区。参与者：总共6158人(总体78.7%；黑人80.5%，白人74.6%)；4.1年后，最初没有AD的人被抽样调查以进行疾病发病率的临床评估(总共842人[74.8%]；67.6%的黑人受试者和81.9%的白人受试者)。干预：没有。主要结果衡量标准：发病率，临床诊断的AD。结果：APOE是一个由4个等位基因组成的因素，对黑人和白人的AD风险的影响存在显著差异。在白人受试者中，APOE的存在是一个4等位基因的元素，与2.73倍(95%可信区间[CI]1.40-5.32)的风险增加有关，而在黑人受试者中，风险没有增加(优势比1.02；95%可信区间0.39-2.68)。如果考虑载脂蛋白E及其与种族的交互作用，黑人种族与AD的风险无显著相关，优势比为1.84(95%CI，0.73-4.66)，如果不考虑APOE及其与种族的交互作用，优势比为1.28(95%CI，0.54-2.98)。65~74岁人群AD发病率为1.45%(95%CI，0.89%~2.01%)，75~84岁人群AD发病率为4.73%(95%CI，3.83%~5.64%)，85岁及以上人群AD发病率为9.11%(95%CI，7.36%~10.9%)。
Context: Few studies compare Alzheimer disease (AD) incidence among black and white subjects.Objective: To estimate incidence and the effect of the apolipoprotein E (APOE) is an element of4 allele in these races.Design: Population-based study of disease incidence using a random, stratified sample.Setting: A geographically defined community of 3 adjacent neighborhoods in Chicago, Ill.Participants: A total of 6158 persons (78.7% overall; 80.5% of the black subjects and 74.6% of the white subjects) participated; 4.1 years later, persons initially free of AD were sampled for clinical evaluation for disease incidence (overall 842 persons [74.8%] participated; 67.6% of the black subjects and 81.9% of the white subjects).Interventions: None.Main Outcome Measure: Incident, clinically diagnosed AD.Results: The effect of the APOE is an element of4 allele on the risk of AD differed strongly for black and white subjects. Among white subjects, the presence of the APOE is an element of4 allele was associated with a 2.73-fold (95% confidence interval [CI] 1.40-5.32) increase in risk while among black subjects there was no increase in risk (odds ratio, 1.02; 95% confidence interval, 0.39-2.68). Black race was associated with a nonsignificantly increased risk of AD with an odds ratio of 1.84 (95% CI,0.73-4.66) if APOE and its interaction with race are considered, and an odds ratio of 1.28 (95% CI, 0.54-2.98) if they are not. The incidence of AD was 1.45% (95% CI, 0.89%-2.01%) per year among persons 65 to 74 years old, 4.73% (95% CI, 3.83%-5.64%) among those 75 to 84 years old, and 9.11% (95% CI, 7.36%-10.9%) among those 85 years and older.Conclusion: Apolipoprotein E is an element of4 led to increased risk of AD among white subjects but not black subjects.