三酰甘油与ApoE基因多态性的交互作用对轻度认知损害进展的影响

Interactive Effect of Triglyceride and ApoE on Progression of Mild Cognitive Impairment

目的探讨三酰甘油(TG)与载脂蛋白E(ApoE)基因多态性的交互作用对轻度认知损害(MCI)进展至阿尔茨海默病(MCI-AD)的影响。方法对来自"上海老年研究队列"中287例年龄>50岁的MCI患者进行平均4.5年的随访,根据DSM-Ⅳ和NINCDS-ADRDA诊断标准诊断为新发AD。基线时采集空腹血样用于TG水平检测和ApoE基因分型。采用Cox回归模型分析TG、ApoEε4及两者交互作用对MCI-AD进展的影响。结果因TG分布呈偏态,故将其转化为lnTG进行统计分析。结果显示lnTG和ApoEε4对MCI-AD进展存在交互作用(PlnTG×ApoE<0.001);在ApoEε4携带者中,lnTG每增加1个单位,MCI-AD进展风险增加4.14倍(校正后HR=5.14,P=0.030),而在ApoEε4非携带者中未发现有显著相关性。结论ApoEε4可修饰TG对MCI-AD进展的影响,充分考虑个体遗传信息有助于在疾病早期识别痴呆易感人群并实施精准干预。

Aim To investigate the interactive effect of triglyceride(TG)and apolipoprotein E(ApoE)on progression of mild cognitive impairment(MCI)to Alzheimer’s disease(AD).Methods A total of 287 MCI patients aged over 50 years were followed up for an average of 4.5 years from the Shanghai Aging Study cohort.New onset AD was diagnosed according to the DSM-and NINCDSADRDA criteria.Fasting blood samples were obtained at baseline for analyzing serum TG and ApoE genotyping.The effect of TG,ApoE and their interaction on MCI-AD progression were analyzed using Cox proportional hazards regression model.Results ln-transformed TG(lnTG)were used in statistical tests because the distribution of TG was skewed.lnTG and ApoEε4 had interactive effect on the MCIAD progression(PlnTG×ApoE<0.001).In APOEε4 carriers,the risk of MCI-AD progression increased by 4.14 times for each unit of lnTG(adjusted HR=5.14,P=0.030),bur no significant correlation was found in ApoEε4 non-carriers.Conclusion ApoEε4 could modified the effect of TG on MCI-AD progression.Full consideration of individual genetic information will help to identify the susceptible population and implement precise intervention in the early stage of cognitive decline.