Health behavior changes after genetic risk assessment for Alzheimer disease: The REVEAL Study
Health behavior changes after genetic risk assessment for Alzheimer disease: The REVEAL Study
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DOI：
10.1097/wad.0b013e31815a9dcc
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发表时间：
2008-01-01
影响因子：
2.1
通讯作者：
Green, Robert C.
中科院分区：
文献类型：
--
作者：
Chao, Serena;Roberts, J. Scott;Green, Robert C.
阿尔茨海默病（AD）的风险信息可以通过易感基因的披露来传达，即使目前还没有临床应用。REVEAL研究是第一个用载脂蛋白E（APOE）基因型和数字风险估计披露进行AD风险评估的随机临床试验。我们研究了无症状AD高危个体的APOE基因型和数字风险披露是否会改变健康行为。162名参与者被随机分配到干预组（APOE披露）或对照组（无基因型披露）。两组受试者均接受了基于性别和AD家族史的未来AD发展的终生风险数值估计。干预组接受其APOE基因型。告知受试者不存在经证实的AD预防措施，并向其提供正在研究的预防治疗信息表。发现自己是AD阳性的参与者比AD阴性的参与者更有可能在披露后1年报告AD特异性健康行为变化（调整后的比值比：2.73; 95%置信区间：1.14，6.54; P = 0.02）。hoe后分析显示，数值终生风险估计和AD特异性健康行为改变的自我报告之间存在类似的显著关联。尽管缺乏AD的预防措施，但对APOE基因型的了解，终生风险的数值，或两者兼而有之，都会影响健康行为。
Risk information for Alzheimer disease (AD) may be communicated through susceptibility gene disclosure, even though this is not currently in clinical use. The REVEAL Study is the first randomized clinical trial of risk assessment for AD with apolipoprotein E (APOE) genotype and numerical risk estimate disclosure. We examined whether APOE genotype and numerical risk disclosure to asymptomatic individuals at high risk for AD alters health behaviors. One hundred sixty-two participants were randomized to either intervention (APOE disclosure) or control (no genotype disclosure) groups. Subjects in both groups received numerical lifetime risk estimates of future AD development based on sex and family history of AD. The intervention group received their APOE genotype. Subjects were informed that no proven preventive measures for AD existed and given an information sheet on preventative therapies under investigation. Participants who learned they were epsilon 4 positive were significantly more likely than epsilon 4 negative participants to report AD-specific health behavior change 1 year after disclosure (adjusted odds ratio: 2.73; 95% confidence interval: 1.14, 6.54; P = 0.02). Post hoe analyses revealed similar significant associations between numerical lifetime risk estimates and self-report of AD-specific health behavior change. Despite lack of preventive measures for AD, knowledge of APOE genotype, numerical lifetime risk, or both, influences health behavior.