社区居住老年人中的载脂蛋白E与脑淀粉样血管病
APOE and cerebral amyloid angiopathy in community-dwelling older persons.
作者信息
Yu Lei, Boyle Patricia A, Nag Sukriti, Leurgans Sue, Buchman Aron S, Wilson Robert S, Arvanitakis Zoe, Farfel Jose M, De Jager Philip L, Bennett David A, Schneider Julie A
机构信息
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
出版信息
Neurobiol Aging. 2015 Nov;36(11):2946-2953. doi: 10.1016/j.neurobiolaging.2015.08.008. Epub 2015 Aug 15.
Both cerebral amyloid angiopathy and Alzheimer's disease pathology involve abnormal β-amyloid processing. We aim to elucidate the relationship of the apolipoprotein E (APOE) genotypes with amyloid angiopathy in the presence of variable amounts of Alzheimer's pathology. Data came from 1062 autopsied subjects from 2 community-based studies of aging. Common neuropathologies including Alzheimer's disease and amyloid angiopathy were assessed using uniform methods. APOE was genotyped by sequencing the 2 polymorphisms in codons 112 and 158 of exon 4. We examined the associations of APOE with amyloid angiopathy using ordinal logistic regression analyses, controlling for demographics and subsequently Alzheimer's and other common pathologies. Moderate to severe amyloid angiopathy was identified in 35.2% (n = 374) of the subjects; 15.3% (n = 162) of the subjects were APOE ε2 carriers; and 26.1% (n = 277) ε4 carriers. Adjusting for demographics, the presence of ε4 allele, but not ε2, was associated with more severe amyloid angiopathy. After further adjustment for Alzheimer's pathology, both ε2 (odds ratio 1.707, 95% confidence interval 1.236-2.358, p = 0.001) and ε4 (odds ratio 2.284, 95% confidence interval 1.730-3.014, p < 0.001) were independently associated with amyloid angiopathy. The results were confirmed by path analysis. Furthermore, APOE ε4 carriers, but not ε2 carriers, were more likely to have capillary amyloid angiopathy. Accounting for capillary involvement did not alter the APOE associations with amyloid angiopathy. We conclude that both APOE ε2 and ε4 alleles are associated with more severe cerebral amyloid angiopathy, and the direct effect of ε2 is masked by the allele's negative association with comorbid Alzheimer's pathology. APOE ε4, but not ε2, is associated with capillary amyloid angiopathy.
脑淀粉样血管病和阿尔茨海默病的病理过程均涉及异常的β-淀粉样蛋白加工。我们旨在阐明在存在不同程度阿尔茨海默病病理改变的情况下,载脂蛋白E(APOE)基因分型与淀粉样血管病之间的关系。数据来自两项基于社区的衰老研究中的1062名尸检对象。使用统一方法评估包括阿尔茨海默病和淀粉样血管病在内的常见神经病理学情况。通过对第4外显子密码子112和158处的两个多态性进行测序来对APOE进行基因分型。我们使用有序逻辑回归分析来研究APOE与淀粉样血管病之间的关联,并对人口统计学因素以及随后的阿尔茨海默病和其他常见病理情况进行控制。35.2%(n = 374)的对象被确定患有中度至重度淀粉样血管病;15.3%(n = 162)的对象是APOE ε2携带者;26.1%(n = 277)是ε4携带者。在对人口统计学因素进行调整后,ε4等位基因的存在而非ε2与更严重的淀粉样血管病相关。在进一步对阿尔茨海默病病理情况进行调整后,ε2(比值比1.707,95%置信区间1.236 - 2.358,p = 0.001)和ε4(比值比2.284,95%置信区间1.730 - 3.014,p < 0.001)均与淀粉样血管病独立相关。路径分析证实了这些结果。此外,APOE ε4携带者而非ε2携带者更有可能患有毛细血管淀粉样血管病。考虑毛细血管受累情况并未改变APOE与淀粉样血管病之间的关联。我们得出结论,APOE ε2和ε4等位基因均与更严重的脑淀粉样血管病相关,并且ε2的直接效应被该等位基因与合并的阿尔茨海默病病理情况的负相关所掩盖。APOE ε4而非ε2与毛细血管淀粉样血管病相关。