Whitehead A S, Bertrandy S, Finnan F, Butler A, Smith G D, Ben-Shlomo Y
Department of Genetics, Trinity College, Dublin, Ireland.
J Neurol Neurosurg Psychiatry. 1996 Oct;61(4):347-51. doi: 10.1136/jnnp.61.4.347.
It has been suggested that Parkinson's disease and Alzheimer's disease may share a common or at least overlapping aetiology. The prevalence of dementia among cases of Parkinson's disease is known to be greater than expected in the general population. The frequency of the apolipoprotein epsilon 4 allele in a large case-control study of early onset Parkinson's disease has been examined.
215 patients and 212 population based controls were recruited from the Republic of Ireland between 1992 and 1994. Cases had to have disease onset at 55 years or younger and be born after 1925.
The frequency of the epsilon 4 allele was almost identical between cases of Parkinson's disease (14.6%) and healthy controls (13.3%). There was no relation between epsilon 4 status and disease onset, disease duration, Hoehn and Yahr score, and disease progression. The frequency of the epsilon 4 allele was not increased among 10 patients with Parkinson's disease with dementia (10.0%) compared with the other patients without dementia (14.8%). There was no association between epsilon 4 allele status and either a history of smoking, family history of dementia, or Parkinson's disease, or being born in a rural area. The odds ratio for the ApoE epsilon 4 allele associated with Parkinson's disease was 1.10 (95% confidence interval (95% CI) 0.68-1.79), adjusting for age group, sex, and residential status. The pooled odds ratio from a meta-analysis of six studies of ApoE epsilon 4 status and Parkinson's disease was 0.94 (95% CI 0.69-1.27).
The results from our study as well as the pooled meta-analysis exclude any important role for ApoE epsilon 4 status in the development of Parkinson's disease. Our results similarly do not support its role either in dementia associated with Parkinson's disease or disease prognosis.
有人提出帕金森病和阿尔茨海默病可能有共同的病因，或者至少病因有重叠。已知帕金森病患者中痴呆症的患病率高于一般人群的预期。在一项关于早发性帕金森病的大型病例对照研究中，对载脂蛋白ε4等位基因的频率进行了检测。
1992年至1994年间从爱尔兰共和国招募了215名患者和212名基于人群的对照。病例必须在55岁或更年轻时发病，且出生于1925年以后。
帕金森病患者（14.6%）和健康对照者（13.3%）中ε4等位基因的频率几乎相同。ε4状态与疾病发病、病程、霍恩和雅尔评分以及疾病进展之间没有关系。与其他无痴呆症的患者（14.8%）相比，10例帕金森病合并痴呆症患者中ε4等位基因的频率没有增加（10.0%）。ε4等位基因状态与吸烟史、痴呆症家族史或帕金森病家族史以及出生在农村地区之间没有关联。调整年龄组、性别和居住状况后，与帕金森病相关的载脂蛋白E ε4等位基因的比值比为1.10（95%置信区间（95%CI）0.68 - 1.79）。对六项关于载脂蛋白E ε4状态与帕金森病的研究进行荟萃分析得出的合并比值比为0.94（95%CI 0.69 - 1.27）。
我们的研究结果以及汇总的荟萃分析排除了载脂蛋白E ε4状态在帕金森病发病过程中的任何重要作用。我们的结果同样不支持其在帕金森病相关痴呆症或疾病预后中的作用。
