Apolipoprotein E ε4 allele is associated with vascular cognitive impairment no dementia in Chinese population

Yue Han; Aihong Zhou; Fangyu Li; Qi Wang; Lingzhi Xu; Jianping Jia

doi:10.1016/j.jns.2019.116606

Apolipoprotein E ε4 allele is associated with vascular cognitive impairment no dementia in Chinese population

J Neurol Sci. 2020 Feb 15:409:116606. doi: 10.1016/j.jns.2019.116606. Epub 2019 Dec 6.

Authors

Yue Han¹, Aihong Zhou¹, Fangyu Li², Qi Wang², Lingzhi Xu², Jianping Jia³

Affiliations

¹ Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China.
² Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China; Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, PR China.
³ Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China; Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, PR China; Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, PR China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, PR China. Electronic address: jjp@ccmu.edu.cn.

PMID: 31865187
DOI: 10.1016/j.jns.2019.116606

Abstract

Background: The association between apolipoprotein E (APOE) ε4 allele and vascular cognitive impairment no dementia (VCIND) is still controversial.

Objective: To examine the relationship between the APOE ε4 allele and patients with VCIND after cerebral infarction.

Methods: This study included first-ever cerebral infarction patients 3-12 months after the attack at the Xuanwu Hospital between June 2012 and December 2014. Patients were divided into VCIND group and normal cognition group (NC group).The APOE ε4 carriers (including ε2/ε4, ε3/ε4 and ε4/ε4 genotypes) and ε4 allele frequency were analyzed in relation to cognition grouping after cerebral infarction. MRI features of infarctions and some known risk factors for VCIND，as confounding factors, were also analyzed for correlation with VCIND at the same time.

Results: Participants (n = 707) were divided into the VCIND (n = 361) and NC (n = 346) groups. The percentage of APOE ε4 carriers was higher in the VCIND group (23.6%) than in the NC group (12.7%, P < .001).The APOE ε4 allele frequency was higher in the VCIND group (12.5%) than in the NC group (6.7%, P = .001). Regardless of other confounding factors, such as male gender (OR = 1.963, 95%CI: 1.394-2.763, P < .001), age (OR = 1.034, 95%CI: 1.017-1.052, P < .001), education (OR = 0.834, 95%CI: 0.795-0.875, P < .001), hypertension (OR = 2.044, 95%CI: 1.460-2.861, P < .001), hyperlipidemia (OR = 0.682, 95%CI: 0.482-0.965, P = .031), infarction lesion diameter (OR = 1.044, 95%CI: 1.017-1.072, P = .001) and white matter lesions (OR = 1.330, 95%CI: 1.126-1.571, P = .001), the APOE ε4 allele was independently associated with VCIND (OR = 2.244, 95%CI: 1.454-3.463, P < .001).

Conclusion: These results confirms the hypothesis that the APOE ε4 allele is a risk factor associated with VCIND after cerebral infarction.

Keywords: Apolipoprotein E; Cerebrovascular disease; Vascular cognitive impairment no dementia; Vascular dementia.

MeSH terms

Adult
Aged
Alleles*
Apolipoprotein E4 / genetics*
Asian People / genetics*
Cognitive Dysfunction / diagnosis
Cognitive Dysfunction / epidemiology
Cognitive Dysfunction / genetics*
Dementia, Vascular / diagnosis
Dementia, Vascular / epidemiology
Dementia, Vascular / genetics*
Female
Humans
Male
Middle Aged
Population Surveillance*
Retrospective Studies

Substances

Apolipoprotein E4