Adamis Dimitrios, Meagher David, Williams John, Mulligan Owen, McCarthy Geraldine
aSligo Mental Health Services bPathology Department, Sligo Regional Hospital, Sligo cCognitive Impairment Research Group (CIRG), Graduate-Entry Medical School University of Limerick, Limerick dSligo Medical Academy, NUI Galway, Galway, Ireland eResearch and Academic Institute of Athens, Athens, Greece.
Psychiatr Genet. 2016 Apr;26(2):53-9. doi: 10.1097/YPG.0000000000000122.
The role of apolipoprotein E (APOE) in Alzheimer's disease and other dementias has been investigated intensively. However, the relationship between APOE and delirium has only recently been explored in studies that have included relatively small samples. A meta-analysis of the published pooled data is timely to explore the relationship between APOE and delirium and to inform further research in this topic. PubMed, EBSCOhost, Google Scholar, Scopus, all EBM Reviews (OVID) and the Cochrane Database of Systematic Reviews were searched with relevant keywords and from the references of relevant papers. Ten papers were found that examined the relationship between APOE and delirium. Data were extracted from eight of them and pooled for meta-analysis using random effects with R software. Data from 1762 participants, of whom 479 (27.2%) were diagnosed with delirium, showed low heterogeneity (Q=13.11, d.f.=7, P=0.07; I=44.86%). The possession of the APOE ε4 allele has a small (log odds ratio: 0.18, 95% confidence interval: 0.23-0.59), nonsignificant (P=0.38) effect on the presence of delirium. No publication bias was identified. The metapower of the pooled data was low (α=0.05, power=0.65). On analysing the studies to date, it seems that there is no association between APOE and the occurrence of delirium. We suggest that further studies are needed with greater number of patients to clarify any association as well as to examine for other patterns of association including relevance for subgroups of patients who develop delirium and for effects on the phenotype of delirium and the outcomes.
载脂蛋白E（APOE）在阿尔茨海默病和其他痴呆症中的作用已得到深入研究。然而，APOE与谵妄之间的关系直到最近才在样本相对较小的研究中得到探索。对已发表的汇总数据进行荟萃分析，有助于及时探究APOE与谵妄之间的关系，并为该主题的进一步研究提供参考。通过使用相关关键词并从相关论文的参考文献中搜索了PubMed、EBSCOhost、谷歌学术、Scopus、所有循证医学综述（OVID）以及Cochrane系统评价数据库。共找到10篇研究APOE与谵妄关系的论文。从其中8篇中提取数据，并使用R软件采用随机效应模型进行汇总以进行荟萃分析。1762名参与者的数据显示，其中479人（27.2%）被诊断为谵妄，异质性较低（Q = 13.11，自由度 = 7，P = 0.07；I² = 44.86%）。携带APOE ε4等位基因对谵妄的发生有较小影响（对数比值比：0.18，95%置信区间：0.23 - 0.59），且无统计学意义（P = 0.38）。未发现发表偏倚。汇总数据的Meta检验效能较低（α = 0.05，效能 = 0.65）。综合分析目前的研究，似乎APOE与谵妄的发生之间不存在关联。我们建议需要开展更多患者参与的进一步研究，以明确是否存在任何关联，并研究其他关联模式，包括对发生谵妄的患者亚组的相关性以及对谵妄表型和结局的影响。
