Sawada H, Udaka F, Izumi Y, Nishinaka K, Kawakami H, Nakamura S, Kameyama M
Department of Neurology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyoku, Kyoto, 606-8507, Japan.
J Neurol Neurosurg Psychiatry. 2000 May;68(5):653-6. doi: 10.1136/jnnp.68.5.653.
Cerebral white matter lesions, such as leukoaraiosis, may be a result of damage from cerebral ischaemia, and may also be associated with the degenerative process in Alzheimer's disease. The apolipoprotein epsilon4 (apoepsilon4) genotype is a genetic risk factor for both Alzheimer's disease and ischaemic brain damage through acceleration of atherosclerosis. The aim was to determine whether apoepsilon4 may be related to the formation of cerebral white matter lesions in Alzheimer's disease. The association of apoE genotype, sex, age, and the presence of several vascular risk factors, with the presence of white matter lesions in 55 patients clinically diagnosed with Alzheimer's disease was investigated. The cerebral white matter lesions were identified by T2 weighted MRI and classified on a 4 grade scale from no lesion to diffuse lesion. The odds ratio (OR) of the factors mentioned above to the presence of white matter lesions was determined and tested by Fisher's exact test. The association of the lesion grades with these factors was analysed by non-parametric tests. The apoE 4 genotype was strongly associated with Alzheimer's disease (p=0.0001), but not associated with the presence or the degree of cerebral white matter lesions in Alzheimer's disease (OR=1.09, p>0.99). Aging (>70 years old) was a significant risk factor for white matter lesions (OR=7.2, p=0.0006) and age was significantly correlated with the lesion (p=0.0075). The OR of female sex to the lesion grades was 2.89 (p=0.084) and the lesion grade of female sex was significantly higher than that of the male sex (p=0.047). Other vascular risk factors were not significantly associated with the presence of white matter lesions. These findings suggest that there is a sex difference in white matter pathology in Alzheimer's disease.
脑白质病变，如脑白质疏松症，可能是脑缺血损伤的结果，也可能与阿尔茨海默病的退行性过程有关。载脂蛋白ε4（apoε4）基因型是阿尔茨海默病和缺血性脑损伤的遗传风险因素，可通过加速动脉粥样硬化导致上述疾病。本研究旨在确定apoε4是否与阿尔茨海默病脑白质病变的形成有关。研究了55例临床诊断为阿尔茨海默病患者的apoE基因型、性别、年龄以及几种血管危险因素与白质病变的关系。通过T2加权磁共振成像（MRI）识别脑白质病变，并根据从无病变到弥漫性病变的4级量表进行分类。通过Fisher精确检验确定并测试上述因素与白质病变存在的比值比（OR）。采用非参数检验分析病变分级与这些因素的相关性。apoE 4基因型与阿尔茨海默病密切相关（p=0.0001），但与阿尔茨海默病脑白质病变的存在或程度无关（OR=1.09，p>0.99）。年龄>70岁是白质病变的重要危险因素（OR=7.2，p=0.0006），且年龄与病变显著相关（p=0.0075）。女性与病变分级的OR为2.89（p=0.084），女性的病变分级显著高于男性（p=0.047）。其他血管危险因素与白质病变的存在无显著相关性。这些发现表明，阿尔茨海默病脑白质病理存在性别差异。
