4111 Pictor Lane, Orlando, FL 32816.
Department of Psychology, University of Central Florida, Orlando, Florida, USA.
J Clin Psychiatry. 2017 Jul;78(7):891-896. doi: 10.4088/JCP.16m10913.
Studies evaluating the effect of apolipoprotein E (APOE) on vascular depression are sparse, employ heterogeneous methods, and yield inconsistent results. One possibility is that APOE is a moderator of another predictor such as cerebrovascular burden. This longitudinal study examines the relationships between APOE, cerebrovascular burden, and depressive symptomatology in a large cohort sample from midlife to later life.
Data include 3,203 participants across 18 years (1993-2011) from the Wisconsin Longitudinal Study (baseline mean age = 53 years). Depressive symptomatology was measured using the Center for Epidemiologic Studies Depression scale. Cerebrovascular burden was operationalized as hypertension, high blood sugar or diabetes, and other heart problems. APOE genotyping was completed using saliva samples. Hypotheses were examined via a moderated path model and binary logistic regression.
Results supported the hypothesized path model (root mean square error of approximation = 0.041; comparative fit index = 0.959); however, APOE-conferred risk was not a significant moderator of the 2004 or 2011 vascular depression effect and only approached significance as a predictor of depression in 2011 (P = .079). The logistic regression yielded APOE as a significant predictor of clinically significant depressive symptoms in 2011 (P = .02, Exp(B) = 1.197).
The present findings suggest that APOE may influence expression of depressive symptomatology as adults age into and beyond their mid-70s but do not indicate APOE as a moderator of vascular depression. Results posit a potential explanation for inconsistent past findings.
评估载脂蛋白 E（APOE）对血管性抑郁症影响的研究较少，采用的方法也存在差异，结果也不一致。一种可能性是 APOE 是另一个预测因子（如脑血管负担）的调节剂。本纵向研究在从中年到老年的大样本队列中，研究了 APOE、脑血管负担与抑郁症状之间的关系。
数据包括来自威斯康星纵向研究的 3203 名参与者（1993-2011 年，基线平均年龄为 53 岁）。抑郁症状采用流行病学研究中心抑郁量表进行测量。脑血管负担定义为高血压、高血糖或糖尿病和其他心脏问题。APOE 基因分型采用唾液样本完成。通过调节路径模型和二元逻辑回归检验假设。
结果支持假设的路径模型（均方根误差近似值 = 0.041；比较拟合指数 = 0.959）；然而，APOE 赋予的风险并不是 2004 年或 2011 年血管性抑郁症效应的显著调节剂，仅在 2011 年作为抑郁症的预测因子接近显著（P = 0.079）。逻辑回归得出 APOE 是 2011 年临床显著抑郁症状的显著预测因子（P = 0.02，Exp（B）= 1.197）。
本研究结果表明，APOE 可能会影响成年人进入 70 多岁及以后时抑郁症状的表达，但并不表明 APOE 是血管性抑郁症的调节剂。结果提出了一个潜在的解释，解释了过去不一致的发现。
