Popovac Aleksandra, Mladenović Irena, Krunić Jelena, Trifković Branka, Todorović Ana, Milašin Jelena, Despotović Nebojša, Stančić Ivica
Department for Prosthetic Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Department of Oral Rehabilitation, Faculty of Medicine, University of East Sarajevo, Foča, Bosnia and Herzegovina.
J Alzheimers Dis. 2020;74(3):797-802. doi: 10.3233/JAD-191283.
Compromised dentition has been suggested to pose a significant risk factor for dementia. It was mainly investigated through insufficient tooth number, disregarding contact between opposing teeth (dental occlusion). The ɛ4 allele of apolipoprotein (APOE4) is the primary genetic marker for the late onset of Alzheimer's disease (AD). However, APOE4 and dental occlusion have not yet been investigated as possible associated risk factors for AD. The study was aimed to examine the impact of dental status and different APOE gene variants on AD occurrence. Secondly, sociodemographic variables were investigated as factors potentially associated with AD. The case-control study included two groups: 116 patients with AD (according to the NINDS-ADRDA criteria) and 63 controls (Mini-Mental State Examination scores ≥24). The analysis of APOE gene polymorphism was conducted through PCR reaction. Dental examination included recording of number of teeth, presence of fixed or removable dentures, and number of functional tooth units (FTU). Regression analysis was used to investigate the joint effect of the clinical and genetic variables on AD. Results showed that patients with AD were more often carriers of ɛ3/ɛ4 genotype and ɛ4 allele, had lower number of teeth and FTU, and were less likely to be married, live in home, and had less chronic diseases, compared to the controls. Regression analysis showed that presence of APOE4 allele and the number of total FTU remained associated with AD, even when adjusted for age, sex, and level of education. In conclusion, deficient dental occlusion and presence of APOE4 may independently increase risk for AD.
牙列受损被认为是痴呆症的一个重要风险因素。以往主要通过牙齿数量不足来进行研究,而忽视了对颌牙齿之间的接触(牙合)情况。载脂蛋白(APOE4)的ε4等位基因是晚发性阿尔茨海默病(AD)的主要遗传标志物。然而,APOE4和牙合尚未被作为AD可能的相关风险因素进行研究。本研究旨在探讨牙齿状况和不同的APOE基因变体对AD发病的影响。其次,对社会人口统计学变量作为可能与AD相关的因素进行了研究。这项病例对照研究包括两组:116例AD患者(根据美国国立神经疾病和中风研究所-阿尔茨海默病及相关疾病协会标准)和63名对照者(简易精神状态检查表得分≥24)。通过聚合酶链反应(PCR)对APOE基因多态性进行分析。牙齿检查包括记录牙齿数量、固定或可摘义齿的存在情况以及功能牙单位(FTU)的数量。采用回归分析来研究临床和遗传变量对AD的联合作用。结果显示,与对照组相比,AD患者更常携带ε3/ε4基因型和ε4等位基因,牙齿数量和FTU较少,结婚的可能性较小、居家生活的可能性较小且患慢性病较少。回归分析表明,即使在对年龄、性别和教育水平进行调整后,APOE4等位基因的存在和总FTU数量仍与AD相关。总之,牙合不足和APOE4的存在可能独立增加AD的风险。