van Duijn C M, Havekes L M, Van Broeckhoven C, de Knijff P, Hofman A
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, Netherlands.
BMJ. 1995 Mar 11;310(6980):627-31. doi: 10.1136/bmj.310.6980.627.
To investigate the hypothesis that differential survival between smokers and non-smokers leading to a decrease in the frequency of the e4 allele of the apolipoprotein E gene may explain the inverse relation between smoking history and early onset Alzheimer's disease.
A population based case-control study.
The four northern provinces of the Netherlands and metropolitan Rotterdam.
175 patients with early onset Alzheimer's disease and two independent control groups of 159 and 457 subjects.
Frequencies of the apolipoprotein e4 allele and relative risk of early onset Alzheimer's disease.
The inverse association between smoking history and early onset Alzheimer's disease could not be explained by a decrease in the frequency of the apolipoprotein e4 allele. Among carriers of this allele with a family history of dementia subjects with a history of smoking had a strongly reduced risk of early onset Alzheimer's disease (odds ratio 0.10 (95% confidence interval 0.01 to 0.87)).
The results suggest that the inverse relation between smoking history and early onset Alzheimer's disease cannot be explained by an increased mortality in carriers of the apolipoprotein e4 allele who smoke. The association is strongly modified by the presence of the apolipoprotein e4 allele as well as by a family history of dementia.
研究一种假说，即吸烟者和非吸烟者之间的差异生存导致载脂蛋白E基因的e4等位基因频率降低，这可能解释吸烟史与早发性阿尔茨海默病之间的负相关关系。
基于人群的病例对照研究。
荷兰北部四省和鹿特丹大都市。
175例早发性阿尔茨海默病患者以及两个分别由159名和457名受试者组成的独立对照组。
载脂蛋白e4等位基因频率和早发性阿尔茨海默病的相对风险。
吸烟史与早发性阿尔茨海默病之间的负相关关系无法通过载脂蛋白e4等位基因频率的降低来解释。在有痴呆家族史的该等位基因携带者中，有吸烟史的受试者患早发性阿尔茨海默病的风险大幅降低（比值比0.10（95%置信区间0.01至0.87））。
结果表明，吸烟史与早发性阿尔茨海默病之间的负相关关系不能用吸烟的载脂蛋白e4等位基因携带者死亡率增加来解释。这种关联受到载脂蛋白e4等位基因的存在以及痴呆家族史的强烈影响。
