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“我们所有人”研究计划中代表性不足群体中与APOE4相关的痴呆风险影响

Impact of APOE4-related dementia risk in underrepresented groups from the All of Us research program.

作者信息

Ghisays Valentina, Khajouei Ehsan, Piras Ignazio S, Malek-Ahmadi Michael H, Protas Hillary D, Goradia Dhruman D, Chen Yinghua, Naymik Marcus, Saner Donald, Veatch Olivia J, Mansel Clayton O, Su Yi, Huentelman Matthew J, Karnes Jason H, Reiman Eric M

机构信息

Banner Alzheimer's Institute, Phoenix, Arizona, USA.

Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, University of Arizona, Tucson, Arizona, USA.

出版信息

Alzheimers Dement. 2025 Jun;21(6):e70245. doi: 10.1002/alz.70245.

Abstract

INTRODUCTION

Longitudinal electronic health records (EHRs), "dementia" diagnostic codes, and genetic data from All of Us were used to see if there is a higher risk of dementia and an attenuated impact of apolipoprotein ε4 (APOE4) on Alzheimer's disease (AD) risk in Black and Hispanic/Latino groups.

METHODS

Participants included 9,784 Hispanic/Latinos, 14,937 Non-Hispanic Blacks (NHB), and 60,388 Non-Hispanic Whites (NHWs) ≥age 60 without an initial dementia diagnosis.

RESULTS

There was a significantly higher risk of developing a dementia diagnosis in Hispanic/Latino and NHB participants than NHW participants and comparably increased dementia hazard ratios in the Hispanic/Latino, NHB, and NHW APOE4 carriers than non-carriers (hazard ratio [HR] [95% confidence interval {CI}] 1.54 [1.25-1.91], 1.25 [1.00-1.57], and 1.55 [1.40-1.72]).

DISCUSSION

Compared to NHW individuals, Hispanic/Latino and NHB individuals are at higher risk of developing a "dementia diagnosis" and comparably higher risk in APOE4 carriers than non-carriers. Plasma AD biomarkers could clarify the proportion of dementia cases with and without AD and the impact of APOE4 on AD in these groups.

HIGHLIGHTS

Hispanic/Latino and non-Hispanic Black individuals have a higher risk of all-cause dementia. The impact of apolipoprotein ε4 (APOE4) on dementia risk was similar in the studied ethnoracial groups. Plasma biomarkers could inform the risk of Alzheimer's disease (AD) and impact of APOE4 in these groups.

摘要

引言

利用纵向电子健康记录(EHR)、“痴呆症”诊断代码以及来自“我们所有人”计划的基因数据,来研究黑人和西班牙裔/拉丁裔群体患痴呆症的风险是否更高,以及载脂蛋白ε4(APOE4)对阿尔茨海默病(AD)风险的影响是否减弱。

方法

参与者包括9784名西班牙裔/拉丁裔、14937名非西班牙裔黑人(NHB)以及60388名年龄≥60岁且最初未被诊断为痴呆症的非西班牙裔白人(NHW)。

结果

西班牙裔/拉丁裔和NHB参与者患痴呆症诊断的风险显著高于NHW参与者,并且西班牙裔/拉丁裔、NHB和NHW的APOE4携带者与非携带者相比,痴呆症风险比同样增加(风险比[HR][95%置信区间{CI}]分别为1.54[1.25 - 1.91]、1.25[1.00 - 1.57]和1.55[1.40 - 1.72])。

讨论

与NHW个体相比,西班牙裔/拉丁裔和NHB个体患“痴呆症诊断”的风险更高,并且APOE4携带者比非携带者的风险同样更高。血浆AD生物标志物可以阐明这些群体中患AD和未患AD的痴呆症病例比例以及APOE4对AD的影响。

要点

西班牙裔/拉丁裔和非西班牙裔黑人个体患全因痴呆症的风险更高。在所研究的种族群体中,载脂蛋白ε4(APOE4)对痴呆症风险的影响相似。血浆生物标志物可以告知这些群体患阿尔茨海默病(AD)的风险以及APOE4的影响。

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