载脂蛋白 E ɛ4 等位基因的存在改变了 2 型糖尿病与认知表现之间的关系：缅因州-锡拉丘兹研究。
Presence of the APOE epsilon4 allele modifies the relationship between type 2 diabetes and cognitive performance: the Maine-Syracuse Study.
机构信息
Department of Psychology, University of Maine, 5742 Little Hall, Orono, ME 04469-5742, USA.
出版信息
Diabetologia. 2009 Dec;52(12):2551-60. doi: 10.1007/s00125-009-1497-2. Epub 2009 Aug 20.
AIMS/HYPOTHESIS: The primary aim of this study was to determine whether the presence of one or more APOE epsilon4 alleles modifies the association between diabetes (defined by glucose > or =7 mmol/l or treatment) and cognitive function.
METHODS
Diabetic status and APOE genotype interactions were assessed cross-sectionally for 826 community-dwelling, stroke-free, non-demented individuals (526 non-diabetic non-APOE epsilon4 carriers, 174 non-diabetic APOE epsilon4 carriers, 87 diabetic APOE epsilon4 non-carriers, 39 diabetic APOE epsilon4 carriers) ranging in age from 50 to 98 years. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the similarities subtest from the Wechsler Adult Intelligence Scale, and four composite scores derived from 17 additional neuropsychological tests. Multiple linear regression analyses were employed to relate diabetes and APOE genotype to cognitive performance and to examine the interaction between these two risk factors as they relate to cognitive performance. Multiple cardiovascular disease risk factors were statistically controlled.
RESULTS
With adjustment for age, education, sex, race/ethnicity and APOE genotype, performance level was lower for the diabetic than for the non-diabetic group for the MMSE, the similarities subtest and each of the cognitive composites with the exception of the verbal memory composite. Interactions (p < 0.05) between diabetes and APOE genotype were found for all but the visual-spatial memory/organisation composite. The negative association between diabetes and cognitive performance was of a higher magnitude for individuals who carry one or more APOE epsilon4 alleles. Results were similar with additional adjustment for cardiovascular disease and associated risk factors.
CONCLUSIONS/INTERPRETATION: The presence of one or more APOE epsilon4 alleles modifies the association between diabetes and cognitive function.
目的/假设：本研究的主要目的是确定一个或多个 APOE epsilon4 等位基因是否会改变糖尿病（定义为血糖≥7mmol/L 或治疗）与认知功能之间的关联。
方法
在年龄为 50 至 98 岁的 826 名无中风、无痴呆的社区居民（526 名非糖尿病非 APOE epsilon4 携带者、174 名非糖尿病 APOE epsilon4 携带者、87 名糖尿病 APOE epsilon4 非携带者、39 名糖尿病 APOE epsilon4 携带者）中，评估了糖尿病状态与 APOE 基因型的相互作用。认知功能采用简易精神状态检查（MMSE）、韦氏成人智力量表相似性测验和来自 17 项额外神经心理学测验的 4 项综合评分进行评估。采用多元线性回归分析将糖尿病和 APOE 基因型与认知表现相关联，并研究这两个危险因素之间的相互作用与认知表现的关系。对多个心血管疾病危险因素进行了统计学控制。
结果
在调整年龄、教育、性别、种族/民族和 APOE 基因型后，与非糖尿病组相比，糖尿病组的 MMSE、相似性测验和认知综合评分中的每项（除了言语记忆综合评分）得分都较低。除了视觉空间记忆/组织综合评分外，还发现了糖尿病和 APOE 基因型之间的相互作用（p<0.05）。在携带一个或多个 APOE epsilon4 等位基因的个体中，糖尿病与认知表现之间的负相关程度更高。当对心血管疾病和相关危险因素进行额外调整时，结果相似。
结论/解释：一个或多个 APOE epsilon4 等位基因的存在改变了糖尿病与认知功能之间的关联。
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