School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Am Geriatr Soc. 2020 May;68(5):1044-1049. doi: 10.1111/jgs.16337. Epub 2020 Feb 4.
To examine the associations of APOE ε2ε4 with the development of Alzheimer's disease (AD) and mild cognitive impairment (MCI) in non-Latino whites.
Prospective longitudinal cohort study.
Uniform Data Set from the National Alzheimer's Coordinating Center (NACC) between 2005 and August 2018 (data freeze in September 2018).
Participants who were non-Latino white, had an APOE genotype available, first visit with dementia free for AD cohort and both dementia and MCI free for MCI cohort, and had a minimum of one follow-up visit (n = 11 871 for AD cohort, and n = 8305 for MCI cohort).
The incidences of AD and MCI were determined based on consensus meetings at each Alzheimer's disease center. We used NACC-derived variables to define individuals experiencing incidents of AD and MCI at the initial visit as well as the follow-up visits.
Among participants in the AD cohort (N = 11 871), ε2ε4 accounted for 2.5%, ε2ε2 accounted for 0.4%, ε2ε3 accounted for 11.0%, ε4ε4 accounted for 4.4%, ε3ε4 accounted for 27.3%, and ε3ε3 accounted for 54.4%. Over an average of 4.6 years follow-up, 1857 (15.6%) developed AD dementia, with the range from 6.0% to 35.2% across the six groups. Compared to ε3ε3 carriers, ε2ε4 carriers exhibited an increased risk of incident AD (18.4% vs 11.7%; adjusted hazard ratio [aHR] = 1.74; 95% confidence interval [CI] = 1.32-2.30; P < .0001). Among participants in the MCI cohort (N = 8305), the average follow-up was 4.7 years, and 1912 (23.0%) developed MCI, with the range from 20.4% to 33.9% across the six groups. Compared to ε3ε3 carriers, ε2ε4 carriers exhibited an increased risk of incident MCI (27.5% vs 21.5%; aHR = 1.52; 95% CI = 1.15-1.99; P = .003).
The APOE ε2ε4 genotype is associated with the increased risk of AD and MCI in non-Latino whites. J Am Geriatr Soc 68:1044-1049, 2020.
研究载脂蛋白 E（APOE）ε2ε4 与非拉丁裔白种人阿尔茨海默病（AD）和轻度认知障碍（MCI）发展的关系。
前瞻性纵向队列研究。
国家阿尔茨海默病协调中心（NACC）统一数据集，时间范围为 2005 年至 2018 年 8 月（数据冻结于 2018 年 9 月）。
非拉丁裔白种人，APOE 基因型可用，AD 队列首次就诊时无痴呆，MCI 队列时无痴呆和 MCI，且至少有一次随访（AD 队列 n = 11871，MCI 队列 n = 8305）。
根据每个阿尔茨海默病中心的共识会议确定 AD 和 MCI 的发生率。我们使用 NACC 衍生变量来定义在初始就诊时以及随访时经历 AD 和 MCI 事件的个体。
在 AD 队列（n = 11871）参与者中，ε2ε4 占 2.5%，ε2ε2 占 0.4%，ε2ε3 占 11.0%，ε4ε4 占 4.4%，ε3ε4 占 27.3%，ε3ε3 占 54.4%。在平均 4.6 年的随访中，有 1857 人（15.6%）发展为 AD 痴呆，6 组的范围为 6.0%至 35.2%。与 ε3ε3 携带者相比，ε2ε4 携带者发生 AD 的风险增加（18.4%比 11.7%；调整后的危险比[aHR] = 1.74；95%置信区间[CI] = 1.32-2.30；P < 0.0001）。在 MCI 队列（n = 8305）参与者中，平均随访时间为 4.7 年，有 1912 人（23.0%）发展为 MCI，6 组的范围为 20.4%至 33.9%。与 ε3ε3 携带者相比，ε2ε4 携带者发生 MCI 的风险增加（27.5%比 21.5%；aHR = 1.52；95%CI = 1.15-1.99；P = 0.003）。
APOE ε2ε4 基因型与非拉丁裔白种人 AD 和 MCI 的风险增加相关。美国老年医学会杂志 68：1044-1049，2020。
