Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian, China.
Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
J Alzheimers Dis. 2021;81(3):1331-1339. doi: 10.3233/JAD-201606.
The apolipoprotein E epsilon 4 (APOE4) is the strongest genetic risk factor for sporadic Alzheimer's disease (AD). Its carriage percentage in non-demented population varies across geographic regions and ethnic groups.
To estimate the proportion of APOE4 (2/4, 3/4, or 4/4) carriers in non-demented community-dwellers.
PubMed, EMBASE, and China National Knowledge Infrastructure were searched from inception to April 20, 2020. Community-based studies that reported APOE polymorphisms with a sample of≥500 non-demented participants were included. Random-effects models were used to pool the results. Meta-regression and subgroup analyses were performed to test the source of heterogeneity and stratified effects. Age-standardized pooled proportion estimates (ASPPE) were calculated by direct standardization method.
A total of 121 studies were included, with a pooled sample of 389,000 community-dwellers from 38 countries. The global average proportion of APOE4 carriers was 23.9% (age-standardized proportion: 26.3%; 2.1% for APOE4/4, 20.6% for APOE3/4 and 2.3% for APOE2/4), and varied significantly with geographical regions (from 19.3% to 30.0%) and ethnic groups (from 19.1% to 37.5%). The proportion was highest in Africa, followed by Europe, North America, Oceania, and lowest in South America and Asia (p < 0.0001). With respect to ethnicity, it was highest in Africans, followed by Caucasians, and was lowest in Hispanics/Latinos and Chinese (p < 0.0001).
APOE4 carriers are common in communities, especially in Africans and Caucasians. Developing precision medicine strategies in this specific high-risk population is highly warranted in the future.
载脂蛋白 E ɛ 4（APOE4）是散发性阿尔茨海默病（AD）最强的遗传风险因素。其在非痴呆人群中的携带率因地理位置和种族群体而异。
估计非痴呆社区居民中 APOE4（2/4、3/4 或 4/4）携带者的比例。
检索了从建库至 2020 年 4 月 20 日的 PubMed、EMBASE 和中国国家知识基础设施数据库。纳入了报告 APOE 多态性且样本量≥500 名非痴呆参与者的基于社区的研究。使用随机效应模型汇总结果。进行了荟萃回归和亚组分析，以检验异质性来源和分层效应。通过直接标准化法计算年龄标准化的汇总比例估计值（ASPPE）。
共纳入 121 项研究，包含来自 38 个国家的 389000 名非痴呆社区居民的汇总样本。APOE4 携带者的全球平均比例为 23.9%（年龄标准化比例：26.3%；APOE4/4 为 2.1%，APOE3/4 为 20.6%，APOE2/4 为 2.3%），且在地理位置（19.3%至 30.0%）和种族群体（19.1%至 37.5%）之间差异显著。在非洲最高，其次是欧洲、北美、大洋洲，在南美和亚洲最低（p<0.0001）。就种族而言，在非洲最高，其次是白种人，在西班牙裔/拉丁裔和中国人中最低（p<0.0001）。
APOE4 携带者在社区中很常见，尤其是在非洲人和白种人中。在未来，非常有必要针对这一特定高危人群制定精准医学策略。
