Kimbrel Nathan A, Hauser Michael A, Garrett Melanie, Ashley-Koch Allison, Liu Yutao, Dennis Michelle F, Klein Rebecca C, Beckham Jean C
Durham Veterans Affairs Medical Center, Durham, North Carolina; The VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Depress Anxiety. 2015 May;32(5):307-15. doi: 10.1002/da.22348. Epub 2015 Feb 24.
The apolipoprotein E (APOE) ε4 allele has been implicated in a range of neuropsychiatric conditions. The present research examined if the ε4 allele of the APOE gene moderated the effect of combat exposure on posttraumatic stress disorder (PTSD) among Iraq/Afghanistan-era veterans.
Participants included 765 non-Hispanic White (NHW) and 859 non-Hispanic Black (NHB) Iraq/Afghanistan-era veterans. A structured interview established psychiatric diagnoses. Combat exposure and PTSD symptom severity were assessed via self-report.
The most common lifetime diagnoses were depression (39.2%), PTSD (38.4%), and alcohol dependence (24.38%). After correcting for multiple comparisons, no significant effects were observed on any of the outcomes among the NHW sample; however, within the NHB sample, significant gene × environment (G × E) interactions were observed for lifetime PTSD (P = .0029) and PTSD symptom severity (P = .0009). In each case, the APOE ε4 allele had no effect on the outcomes when combat exposure was low; however, when combat exposure was high, an additive effect was observed such that ε4 homozygotes exposed to high levels of combat reported the highest rates of PTSD (92%) and the worst symptom severity scores on the Davidson Trauma Scale (M = 79.5).
Although preliminary, these findings suggest that the APOE ε4 allele, in conjunction with exposure to high levels of combat exposure, may increase veterans' risk for developing PTSD.
载脂蛋白E（APOE）ε4等位基因与一系列神经精神疾病有关。本研究探讨了APOE基因的ε4等位基因是否会调节伊拉克/阿富汗战争时期退伍军人中战斗暴露对创伤后应激障碍（PTSD）的影响。
研究对象包括765名非西班牙裔白人（NHW）和859名非西班牙裔黑人（NHB）伊拉克/阿富汗战争时期退伍军人。通过结构化访谈确定精神疾病诊断。通过自我报告评估战斗暴露情况和PTSD症状严重程度。
最常见的终生诊断为抑郁症（39.2%）、PTSD（38.4%）和酒精依赖（24.38%）。在进行多重比较校正后，在NHW样本的任何结果中均未观察到显著影响；然而，在NHB样本中，观察到终生PTSD（P = 0.0029）和PTSD症状严重程度（P = 0.0009）存在显著的基因×环境（G×E）相互作用。在每种情况下，当战斗暴露程度较低时，APOE ε4等位基因对结果没有影响；然而，当战斗暴露程度较高时，观察到一种累加效应，即暴露于高水平战斗的ε4纯合子报告的PTSD发生率最高（92%），并且在戴维森创伤量表上的症状严重程度得分最差（M = 79.5）。
尽管这些发现是初步的，但表明APOE ε4等位基因与高水平的战斗暴露相结合，可能会增加退伍军人患PTSD的风险。
