老年人轻度认知功能损害与ApoE基因多态性关系  

Relationship between Apo E gene polymorphism and risk of different subtypes of mild cognitive impairment

作　　者：陈静[1] 黄文湧[1] 杨敬源[1] 杨星[1] 汪俊华[1] 蔡毅媛[1] 韦继芳[1] 

机构地区：[1]贵阳医学院公共卫生学院流行病学教研室,贵州贵阳550004

出　　处：《中国公共卫生》2011年第7期836-838,共3页Chinese Journal of Public Health

基　　金：国家自然科学基金(30860245);贵州省省长资金项目[黔省专合字(2007)47)];贵州省科技攻关项目(黔科合S字[2007]1042);贵阳市科技项目(筑科大合字[2009]-6)

摘　　要：目的探讨社区老年人轻度认知功能损害(MC I)及其亚型发病与Apo E基因多态性的关系。方法对贵州省贵阳市城区≥60岁认知功能正常老年人2 207名随访3年后,选择新发MC I患者和相应对照进行1∶2匹配巢式病例对照研究;Apo E等位基因分型测定采用限制性片段长度多态性分析技术(RFLP-PCR);采用COX模型拟合条件Logistic回归分析法进行影响因素分析。结果 MC I新发病例105例,发病密度为18.2/千人年;其中遗忘型发病密度为12.9/千人年;非遗忘型发病密度为5.4/千人年;单因素分析显示,携带Apo Eε4基因是未分型MC I和遗忘型MC I发病的共同危险因素(OR=2.463,95%CI=1.372～4.433;OR=2.824,95%CI=1.375～5.876),携带Apo Eε2基因是非遗忘型MC I发病的危险因素(OR=3.688,95%CI=1.140～11.930);而携带Apo Eε3基因可降低未分型MC I及非遗忘型MC I的发病风险(OR=0.478,95%CI=0.275～0.864;OR=0.380,95%CI=0.147～0.984);控制受教育程度及相关血脂因素后,携带Apo Eε4基因仍然是老年人发生MC I尤其是遗忘型MC I的危险因素(未分型OR=2.686,95%CI=1.407～5.127;遗忘型OR=2.743,95%CI=1.260～5.970);对非遗忘型MC I有影响的Apo E基因亚型仅为ε3型(OR=0.305,95%CI=0.103～0.899)。结论 Apo E基因多态性对社区老年人群MC I及其不同亚型发病的影响可能存在一定差异。携带Apo Eε4基因是未分型MC I和遗忘型MC I发病共同的独立危险因素,而ApoEε3基因可能防止非遗忘型MC I的发生。Objective To explore the relationship between Apo E gene polymorphism and the risk of mild cognitive impairment（MCI） and its subtypes among the community elderly population.Methods A 1∶2 matched nested case-control study was conducted on the basis of a cohort of 2 207 individuals aged 60 and over with normal cognitive function in Guiyang city.According to the results of mini-mental state examination（MMSE） screening,the subjects were selected based on the outcome at the end of a 3 years follow-up.All of the subjects were genotyped for Apo E with restriction fragment length polymorphism（RFLP）-PCR.The data was analyzed by using fitted conditional logistic regression with Cox regression model.Results During the 3 years follow-up,105 new cases of MCI were diagnosed with an estimated incidence density of 18.2 per 1 000 person-years.The cases included 74 amnestic MCI with an estimated incidence density of 12.9 per 1 000 person-years,and 31 non-amnestic MCI with an estimated incidence density of 5.4 per 1 000 person-years.Single-factor analysis showed that Apo E ε4 gene was a common risk factor to the incidence of total MCI and amnestic MCI（odds ratio=2.463,95% confidence interval：1.372-4.433;OR=2.824,95% CI：1.375-5.876）.Apo E ε2 gene increased the risk of non-amnestic MCI（OR=3.688,95% CI：1.140-11.930）.While Apo E ε3 gene might reduce the incidence of non-amnestic MCI and total MCI（OR=0.478,95% CI：0.275-0.864;OR=0.380,95% CI：0.147-0.984）.After adjustment for education and relevant vascular risk factors,Apo E ε4 allele was still related to a significantly higher risk of total MCI,especially amnestic MCI（OR=2.686,95% CI：1.407-5.127;OR=2.743,95% CI：1.260-5.970）.However,non-amnestic MCI was associated with Apo E ε3 allele（OR=0.305,95% CI：0.103-0.899）.Conclusion Apo E gene polymorphism had different effects on the incidence of subtypes of MCI among the elderly in community.Apo E ε4 gene is a common independent risk factor for total MCI and amnestic MCI.Conversely,Apo E �

关 键 词：轻度认知功能障碍(MCI) 亚型 APOE基因 巢式病例对照研究 

分 类 号：R395.2[哲学宗教—心理学]