Presence of the APOE ε4 allele modifies the relationship between type 2 diabetes and cognitive performance: the Maine-Syracuse Study

被引:61
作者
Dore, G. A. [1 ]
Elias, M. F. [1 ,2 ]
Robbins, M. A. [1 ,2 ]
Elias, P. K. [1 ]
Nagy, Z. [3 ]
机构
[1] Univ Maine, Dept Psychol, Orono, ME 04469 USA
[2] Univ Maine, Grad Sch Biomed Sci, Orono, ME 04469 USA
[3] Univ Birmingham, Sch Clin & Expt Med, Coll Med & Dent Sci, Birmingham, W Midlands, England
关键词
Apolipoprotein E; Cognition; Type; 2; diabetes; APOLIPOPROTEIN-E GENOTYPE; ALZHEIMERS-DISEASE; RISK-FACTORS; DECLINE; HOMOCYSTEINE; AGE; DEPOSITION; DEMENTIA; VITAMINS; INSULIN;
D O I
10.1007/s00125-009-1497-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The primary aim of this study was to determine whether the presence of one or more APOE epsilon 4 alleles modifies the association between diabetes (defined by glucose a parts per thousand yen7 mmol/l or treatment) and cognitive function. Diabetic status and APOE genotype interactions were assessed cross-sectionally for 826 community-dwelling, stroke-free, non-demented individuals (526 non-diabetic non-APOE epsilon 4 carriers, 174 non-diabetic APOE epsilon 4 carriers, 87 diabetic APOE epsilon 4 non-carriers, 39 diabetic APOE epsilon 4 carriers) ranging in age from 50 to 98 years. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the similarities subtest from the Wechsler Adult Intelligence Scale, and four composite scores derived from 17 additional neuropsychological tests. Multiple linear regression analyses were employed to relate diabetes and APOE genotype to cognitive performance and to examine the interaction between these two risk factors as they relate to cognitive performance. Multiple cardiovascular disease risk factors were statistically controlled. With adjustment for age, education, sex, race/ethnicity and APOE genotype, performance level was lower for the diabetic than for the non-diabetic group for the MMSE, the similarities subtest and each of the cognitive composites with the exception of the verbal memory composite. Interactions (p < 0.05) between diabetes and APOE genotype were found for all but the visual-spatial memory/organisation composite. The negative association between diabetes and cognitive performance was of a higher magnitude for individuals who carry one or more APOE epsilon 4 alleles. Results were similar with additional adjustment for cardiovascular disease and associated risk factors. The presence of one or more APOE epsilon 4 alleles modifies the association between diabetes and cognitive function.
引用
收藏
页码:2551 / 2560
页数:10
相关论文
共 45 条
[1]   β-Amyloid deposition in brains of subjects with diabetes [J].
Alafuzoff, I. ;
Aho, L. ;
Helisalmi, S. ;
Mannermaa, A. ;
Soininen, H. .
NEUROPATHOLOGY AND APPLIED NEUROBIOLOGY, 2009, 35 (01) :60-68
[2]   Standards of Medical Care in Diabetes-2009 [J].
不详 .
DIABETES CARE, 2009, 32 :S13-S61
[3]   The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function [J].
Awad, N ;
Gagnon, M ;
Messier, C .
JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, 2004, 26 (08) :1044-1080
[4]   APOE and cognitive decline in preclinical Alzheimer disease and non-demented aging [J].
Bunce, D ;
Fratiglioni, L ;
Small, BJ ;
Winblad, B ;
Bäckman, L .
NEUROLOGY, 2004, 63 (05) :816-821
[5]   Apolipoprotein E, B vitamins, and cognitive function in older adults [J].
Bunce, D ;
Kivipelto, M ;
Wahlin, Å .
JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES, 2005, 60 (01) :P41-P48
[6]   Reduced hippocampal insulin-degrading enzyme in late-onset Alzheimer's disease is associated with the apolipoprotein E-ε4 allele [J].
Cook, DG ;
Leverenz, JB ;
McMillan, PJ ;
Kulstad, JJ ;
Ericksen, S ;
Roth, RA ;
Schellenberg, GD ;
Jin, LW ;
Kovacina, KS ;
Craft, S .
AMERICAN JOURNAL OF PATHOLOGY, 2003, 162 (01) :313-319
[7]   Cognitive decline and dementia in diabetes - systematic overview of prospective observational studies [J].
Cukierman, T ;
Gerstein, HC ;
Williamson, JD .
DIABETOLOGIA, 2005, 48 (12) :2460-2469
[8]   Homocysteine and cognitive performance: Modification by the ApoE genotype [J].
Elias, Merrill F. ;
Robbins, Michael A. ;
Budge, Marc M. ;
Elias, Penelope K. ;
Dore, Gregory A. ;
Brennan, Suzanne L. ;
Johnston, Carole ;
Nagy, Zsuzsanna .
NEUROSCIENCE LETTERS, 2008, 430 (01) :64-69
[9]   Homocysteine, folate, and vitamins B6 and B12 blood levels in relation to cognitive performance:: The Maine-Syracuse study [J].
Elias, Merrill F. ;
Robbins, Michael A. ;
Budge, Marc M. ;
Elias, Penelope K. ;
Brennan, Suzanne L. ;
Johnston, Carole ;
Nagy, Zsuzsanna ;
Bates, Christopher J. .
PSYCHOSOMATIC MEDICINE, 2006, 68 (04) :547-554
[10]   Framingham stroke risk profile and lowered cognitive performance [J].
Elias, MF ;
Sullivan, LM ;
D'Agostino, RB ;
Elias, PK ;
Beiser, A ;
Au, R ;
Seshadri, S ;
DeCarli, C ;
Wolf, PA .
STROKE, 2004, 35 (02) :404-409