Berge Guro, Sando Sigrid B, Rongve Arvid, Aarsland Dag, White Linda R
Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Neurology, University Hospital of Trondheim, Trondheim, Norway.
J Neurol Neurosurg Psychiatry. 2014 Nov;85(11):1227-31. doi: 10.1136/jnnp-2013-307228. Epub 2014 Mar 17.
Results conflict concerning the relevance of APOE alleles on the development of dementia with Lewy bodies (DLB), though they are well established in connection with Alzheimer's disease (AD). The role of APOE alleles in a Norwegian cohort of patients with DLB was therefore examined compared with patients with AD and healthy control individuals.
The study included 156 patients with DLB diagnosed according to the consensus criteria guidelines, 519 patients diagnosed with AD according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ARDRA) criteria and 643 healthy elderly volunteers. Patients were recruited through hospitals, outpatient clinics, nursing homes or from local care authorities in central and south-western parts of Norway. Healthy individuals were recruited from caregivers and societies for retired people.
Subjects carrying an APOE ε2 allele had a reduced risk for developing DLB (OR 0.4, CI 0.3 to 0.8, p=0.004), and the onset of disease was delayed by 4 years (p=0.01, Mann-Whitney U test). Conversely, the APOE ε4 allele increased the risk for development of DLB (OR 5.9, CI 2.7 to 13.0, p<0.0005 for homozygotes). Similar results were found for patients with AD regarding the effect of APOE ε2, though the protective effect appeared to be slightly less pronounced than in DLB. This study is one of the largest regarding DLB and APOE to date.
The results indicate that APOE ε2, a protective factor in AD, has a clear beneficial effect on the development of DLB also.
尽管载脂蛋白E（APOE）等位基因与阿尔茨海默病（AD）的关联已得到充分证实，但关于其在路易体痴呆（DLB）发生发展中的相关性，研究结果存在冲突。因此，本研究比较了挪威一组DLB患者与AD患者及健康对照个体中APOE等位基因的作用。
本研究纳入了156例根据共识标准指南诊断为DLB的患者、519例根据美国国立神经疾病与中风研究所/阿尔茨海默病及相关疾病协会（NINCDS/ARDRA）标准诊断为AD的患者以及643名健康老年志愿者。患者通过挪威中部和西南部的医院、门诊诊所、养老院或当地护理机构招募。健康个体从护理人员和退休人员协会招募。
携带APOE ε2等位基因的受试者患DLB的风险降低（OR 0.4，CI 0.3至0.8，p = 0.004），且发病延迟4年（p = 0.01，曼-惠特尼U检验）。相反，APOE ε4等位基因增加了患DLB的风险（OR 5.9，CI 2.7至13.0，纯合子p<0.0005）。在AD患者中，关于APOE ε2的作用也发现了类似结果，尽管其保护作用似乎不如在DLB中明显。本研究是迄今为止关于DLB和APOE的最大规模研究之一。
结果表明，APOE ε2作为AD中的一个保护因素，对DLB的发生发展也有明显的有益作用。
