载脂蛋白ε-4等位基因与中国晚发性阿尔茨海默病患者认知功能的两年进展
Apolipoprotein epsilon-4 allele and the two-year progression of cognitive function in Chinese subjects with late-onset Alzheimer's disease.
作者信息
Lam Linda C W, Tang Nelson L S, Ma S L, Lui Victor W C, Chan Agnes S Y, Leung P Y, Chiu Helen F K
机构信息
Department of Psychiatry, the Chinese University of Hong Kong, Shatin, Hong Kong, SAR.
出版信息
Am J Alzheimers Dis Other Demen. 2006 Mar-Apr;21(2):92-9. doi: 10.1177/153331750602100208.
BACKGROUND
Although the significance of apolipoprotein E4 (Apo E4) in Alzheimer's disease (AD) has been well established in Caucasian populations, its role in determining the rate of cognitive decline in other ethnic groups has yet to be determined. This study examined the two-year progression of cognitive decline and its association with Apo E4 allelic status in a group of Chinese elderly subjects with AD.
METHOD
One hundred and four Chinese subjects with mild and moderate AD as assessed by the Clinical Dementia Rating (CDR 1 and 2) were followed up at a mean (SD) duration of 22.53 (5.21) months. The rate of cognitive decline and its association with Apo E4 allelic status was evaluated
RESULTS
At follow-up, 74 (73 percent) subjects were reassessed. Forty-nine remained stable at the same CDR and 25 had deteriorated. The mean (SD) deterioration in the Mini-Mental State Examination (MMSE) was 2.52 (4.38) and in the Mattis Dementia Rating Scale (DRS) was 9.03 (14.98) (paired t-test, p < 0. 001). There was no significant difference in the baseline MMSE and DRS scores between the "stable", "deteriorated", or "deceased" groups. Mildly demented subjects with the Apo E4 allele were more likely to have deteriorated to a more severe CDR than subjects without the Apo E4 allele (Pearson chi2 = 5.72, df 1, p = 0.017, Odds ratio = 6.3, CI 1.3 to 30.53).
CONCLUSION
The presence of the Apo E4 allele may influence the rate of cognitive deterioration, particularly in subjects with mild AD.
背景
尽管载脂蛋白E4（Apo E4）在白种人群阿尔茨海默病（AD）中的重要性已得到充分证实，但其在其他种族人群认知衰退速率方面的作用尚未明确。本研究调查了一组患有AD的中国老年受试者认知衰退的两年进展情况及其与Apo E4等位基因状态的关联。
方法
对104名经临床痴呆评定量表（CDR 1和2）评估为轻度和中度AD的中国受试者进行随访，平均（标准差）随访时长为22.53（5.21）个月。评估认知衰退速率及其与Apo E4等位基因状态的关联。
结果
随访时，74名（73%）受试者接受了重新评估。49名受试者的CDR保持稳定，25名受试者病情恶化。简易精神状态检查表（MMSE）的平均（标准差）恶化值为2.52（4.38），马蒂斯痴呆评定量表（DRS）的平均（标准差）恶化值为9.03（14.98）（配对t检验，p < 0.001）。“病情稳定”、“病情恶化”或“死亡”组之间的基线MMSE和DRS评分无显著差异。携带Apo E4等位基因的轻度痴呆受试者比未携带Apo E4等位基因的受试者更有可能恶化为更严重的CDR（Pearson卡方检验=5.72，自由度1，p = 0.017，优势比=6.3，可信区间1.3至30.53）。
结论
Apo E4等位基因的存在可能会影响认知衰退速率，尤其是在轻度AD患者中。
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