APOLIPOPROTEIN E4 ALLELE AND COGNITIVE DECLINE IN ELDERLY MEN
APOLIPOPROTEIN E4 ALLELE AND COGNITIVE DECLINE IN ELDERLY MEN
复制标题
DOI：
10.1136/bmj.309.6963.1202
复制
发表时间：
1994-11-05
影响因子：
--
通讯作者：
KROMHOUT, D
中科院分区：
文献类型：
--
作者：
FESKENS, EJM;HAVEKES, LM;KROMHOUT, D
目的确定载脂蛋白e多态性（尤其是e4等位基因）是否能预测普通人群的认知能力下降。设计：在1990年和1993年进行了以人口为基础的队列调查。背景：荷兰的祖特芬。研究对象：538名年龄在70-89岁的荷兰男性的代表性队列。主要观察指标：认知功能通过迷你精神状态检查评估，认知功能改变和三年内认知功能受损的发生率。结果：e4等位基因携带者的认知功能受损基线患病率（精神状态检查总分小于或等于25分）高于无该等位基因的男性(41.0% (55)vs 31.1% (122) P=0.03)，在调整年龄、职业、吸烟、饮酒和心血管疾病等因素后，这一结果仍然有效。e4纯合子组3年认知功能下降幅度最大（-2.4分），e4杂合子组中等（-0.7分），无e4的组最低（-0.1分），且与其他危险因素无关（P=0.02）。随访期间，等位基因携带者发生认知功能受损的风险明显高于非携带者(27.6% （16/58)vs 15.5%(32/207)）。校正后的优势比为2.87（95%可信区间1.29 ~ 6.42）。在这一人群中，22%的认知功能受损风险可能归因于e4等位基因。结论：载脂蛋白e4等位基因易导致老年男性认知能力下降。
Objectives-To determine whether polymorphism of apolipoprotein E-notably, the e4 allele- predicts cognitive deterioration in the general population.Design-Population based cohort investigated in 1990 and in 1993.Setting-Zutphen, the Netherlands.Subjects-Representative cohort of 538 Dutch men aged 70-89 at baseline.Main outcome measures-Cognitive function assessed by mini mental state examination, change in cognitive function and incidence of impaired cognitive function at three years.Results-The baseline prevalence of impaired cognitive function (mini mental state examination score less than or equal to 25) was higher among carriers of the e4 allele compared wth men without the allele (41.0% (55) v 31.1% (122) P=0.03), and this result was still valid after adjustment for age, occupation, smoking, alcohol use, and cardiovascular diseases. The decline in cognitive function at three years was largest in men homozygous for e4 (-2.4 points), intermediate in those heterozygous for e4 (-0.7 points), and lowest in men without e4 (-0.1 points), and it was independent of other risk factors (P=0.02). The risk of developing impaired cognitive function during follow up was significantly increased in allele carriers compared with non-carriers (27.6% (16/58) v 15.5% (32/207)). The adjusted odds ratio was 2.87 (95% confidence interval 1.29 to 6.42). Twenty two per cent of the risk of developing impaired cognitive function in this population may be attributable to the e4 allele.Conclusions-The apolipoprotein e4 allele predisposes to cognitive decline in a general population of elderly men.