van Exel E, Eikelenboom P, Comijs H C, Kurniawan C, Frölich M, Smit J H, Stek M L, Scheltens P, Eefsting J E, Westendorp R G J
VUMC/ GGZ inGeest, Amsterdam.
Tijdschr Psychiatr. 2011;53(9):637-43.
It has still not been established unequivocally whether vascular risk factors and inflammatory reactions, determined by heredity, are a cause or a result of Alzheimer's disease
If the offspring of parents with AD have more risk factors and more frequent and severe inflammatory reactions than the offspring of parents without AD , this argues strongly in favor of a causal relationship between vascular risk factors, a pro-inflammatory cytokine response and AD.
To determine whether the offspring of parents with ad have more risk factors and more frequent and severe inflammatory reactions than the offspring of parents without ad. method Vascular risk-factors, pro-inflammatory cytokines and the apoe genotype were determined in 206 offspring of parents with ad and in 200 offspring of parents without AD.
Offspring of parents with ad carried more apoe epsilon4 than offspring of parents without ad (47% vs 21%). Middle-aged offspring of parents with a history of ad also had higher blood pressure and a greater atherosclerotic burden than the offspring of parents without AD. Also their response to the pro-inflammatory cytokine was significantly higher.
Hypertension and an inherited pro-inflammatory cytokine profile in middle age are early risk factors that contribute to the development of ad in old age. Offspring with a parental history of AD should therefore be offered screening and treatment for hypertension and have their blood pressure checked so that the development of AD in old age can be prevented.
血管危险因素和由遗传决定的炎症反应究竟是阿尔茨海默病的病因还是结果，目前仍未明确确定。
如果患有阿尔茨海默病的父母的后代比未患阿尔茨海默病的父母的后代有更多的危险因素以及更频繁、更严重的炎症反应，这将有力地支持血管危险因素、促炎细胞因子反应与阿尔茨海默病之间存在因果关系。
确定患有阿尔茨海默病的父母的后代是否比未患阿尔茨海默病的父母的后代有更多的危险因素以及更频繁、更严重的炎症反应。方法：对206名患有阿尔茨海默病的父母的后代和200名未患阿尔茨海默病的父母的后代进行血管危险因素、促炎细胞因子和载脂蛋白E基因型的测定。
患有阿尔茨海默病的父母的后代携带载脂蛋白E4的比例高于未患阿尔茨海默病的父母的后代（47%对21%）。有阿尔茨海默病家族史的父母的中年后代的血压也更高，动脉粥样硬化负担更重。而且他们对促炎细胞因子的反应也明显更高。
中年时期的高血压和遗传性促炎细胞因子特征是导致老年期阿尔茨海默病发生的早期危险因素。因此，有阿尔茨海默病家族史的后代应接受高血压筛查和治疗，并检查血压，以预防老年期阿尔茨海默病的发生。
