中国人群轻度认知功能障碍与载脂蛋白E基因多态性相关性的Meta分析

doi:10.3969/j.issn.1004-583X.2016.03.020

摘要/Abstract

摘要： 目的系统评价中国人群轻度认知功能障碍(MCI)与载脂蛋白E(ApoE)基因多态性的相关性。方法计算机检索PubMed、万方数据库、维普、中国知网及中国生物医学文献数据库,检索时间2005年1月至2015年3月,收集有关ApoE基因多态性与中国人群MCI相关的文献。采用RevMan 5.0软件进行数据合并及一致性检验并评估发表偏倚。结果共11篇文献纳入研究,纳入人群5 200人,MCI组1 416例,对照组3 784例。ApoE ε4等位基因及ε4/4、ε3/4、ε2/4基因型携带者MCI易感性升高,差异有统计学意义;各基因型MCI的发病风险与基因型ε3/3人群比较中:基因型为ε4/4人群增高2.86倍(OR=2.86,95%CI=1.67～4.90,P＜0.01);基因型为ε3/4人群增高2.01倍(OR=2.01,95%CI=1.70～2.38,P＜0.01);基因型为ε2/4人群增高1.71倍(OR=1.75,95%CI=1.21～2.53,P＜0.01)。各等位基因MCI的发病风险与等位基因ε3人群相比较:等位基因为ε4人群增高2.06倍(OR=2.06,95%CI=1.69～2.51,P＜0.01)。ApoEε2/3基因型携带者MCI易感性降低(ε2/3 vs ε3/3:OR=0.80,95%CI=0.66～0.97,P=0.02)。MCI的发病风险在基因型ε2/2及等位基因ε2人群的未见统计学差异。结论中国人群ApoE等位基因ε4与MCI发病存在关系;等位基因ε3可能为MCI的保护基因,等位基因ε2与MCI发病未发现相关性。

关键词: 轻度认知障碍, 载脂蛋白E类, 基因多态性, meta分析

Abstract: Objective To review systematically the correlation between genetic polymorphism of apolipoprotein E (ApoE) and mild cognitive impairment (MCI) in Chinese population.Methods A comprehensive search was conducted up between Jan 2005 and Mar 2015 in the following databases: PubMed, WanFang Database, VIP database, CNKI and Chinese biomedical literature database. The literature of correlation between genetic polymorphism of ApoE and mild cognitive impairment in Chinese population were collected. RevMan 5.0 was adopted for investigating heterogeneity among individual studies and for summarizing all the studies.Results There were totally 11 case-controlled studies including 1 416 patients with MCI and 1 183 control people. The meta-analysis showed that individuals with ApoE ε4 alleles and ε4/4, ε3/4, ε2/4 genotypes were significantly associated with the risk of MCI. Compared with genotype ε3/3, the MCI risk increased by 2.86 times in population with genotype ε4/4 (OR=2.86,95%CI=1.67-4.90,P＜0.001); the MCI increased by 2.01 times in population with genotype ε3/4(OR=2.01,95%CI=1.70-2.38,P＜0.001); the MCI risk increased by 1.71 times in t population with genotype ε2/4(OR=1.75,95%CI=1.21-2.53,P＜0.001); Compared with genotype ε3, the MCI risk increased by 2.06 times (OR=2.06, 95%CI=1.69-2.51,P＜0.001). The susceptibility to MCI in ApoE ε2/3 genotype was significantly decreased(ε2/3 vs ε3/3: OR=0.80, 95%CI=0.66-0.97,P=0.02). There were no significant difference between ApoE ε2/2 genotype, ε2 alleles and the onset risk of MCI.Conclusion ApoE ε4 alleles is related to the onset of MCI in Chinese population, ApoE ε3 alleles may be the protective gene of MCI and ApoE ε2 alleles shows no correlation with the onset of MCI.

Key words: mild cognitive impairment, apolipoproteins E, gene polymorphism, meta analysis

中图分类号:

R741

张洁,周晓辉,罗坤. 中国人群轻度认知功能障碍与载脂蛋白E基因多态性相关性的Meta分析[J]. 临床荟萃, 2016, 31(3): 315-321.

Zhang Jie, Zhou Xiaohui, Luo Kun. Association between mild cognitive impairment and apolipoprotein E genetic polymorphism in Chinese population: a meta-analysis[J]. Clinical Focus, 2016, 31(3): 315-321.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2016.03.020

https://huicui.hebmu.edu.cn/CN/Y2016/V31/I3/315

参考文献

[1] Grundman M,Petersen RC,Ferris SH,et al. Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinic trial[ J]. Arch Neurol,2004,61(1):59-66.
[2] Landa SM,Harvey D,Masison CM,et al. Comparing predictors of conversion and decline in mild cognitive impairment[J]. Neurolog,2010,75(3):230-238.
[3] Siest G,Pillot T,Regis-Bailly A,et al.Apolipoprotein E:an important gene and protein to follow in laboratory medicine[J].Clin Chem,1995,41(8 Pt 1):1068-1086.
[4] Levy-Lahad E,Bird TD.Genetic factors in Alzheime’s disease:a review ofrecent advances[ J].Ann Neurol,1996,40(6):829-840.
[5] 宋元英,宋歌,李玉新. 载脂蛋白E 与阿尔茨海默病的关系研究进展[J]. 中国老年学杂志,2006,26(8):1149-1152.
[6] Petersen RC.Mild cognitive impairment: a diagnostic entity[J].J Inter Med,2004,256(3):183-194.
[7] American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.4 ed (DsM-IV)[M].Washington DC:APA,1994:256-258.
[8] 曾宪涛,刘慧,陈曦,等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志,2012,4(4):297-299.
[9] Wang Z, Ma W, Rong Y, et al.The Association between apolipoprotein E gene polymorphism and mild cognitive impairment among different ethnic minority groups in China[J]. Int J Alzheimers Dis,2014,2014:150628.
[10] Wang X, Wang H, Li H, et al.Frequency of the apolipoprotein E ε4 allele in a memory clinic cohort in Beijing: a naturalistic descriptive study[J].PLoS One,2014,9(6):e99130.
[11] 丁玎.老年认知障碍的人群患病率调查及遗传流行病学研究[D].复旦大学,2012.
[12] 任称发.ApoE基因多态性与江西地区汉族老年人AD及MCI的相关性研究[D].南昌大学,2013.
[13] 叶妮,张临洪.载脂蛋白E基因多态性与轻度认知障碍相关性研究[J].中国神经免疫学和神经病学杂志,2008,15(1):74-75.
[14] 吕小荣,钟远.轻度认知障碍及阿尔茨海默病与载脂蛋白E基因多态性的相关性[J].中国老年学杂志,2012,32(5):917-919.
[15] 岳春贤,张志珺,宇辉,等. 载脂蛋白 E 及淀粉样蛋白变性相关基因多态性与遗忘型轻度认知障碍的关联性研究[J]. 中华神经科杂志,2013,46(5) :295- 300.
[16] 徐明明,易咏红,张萌等.轻度认知功能障碍与ApoE基因多态性及血脂水平的研究[J].山东大学学报:医学版,2009,47(11):103-107.
[17] 汪青松,徐芳,许乃银,等.载脂蛋白Eε4等位基因与轻度认知损害患者认知功能的缺损有关[J].东南国防医药,2006,8(6):405-407.
[18] 沈芳芳,谢云.糖尿病伴轻度认知功能障碍与 ApoE、TNF-α基因多态性的关系[J].山东医药,2014,(25):70-72.
[19] 陈静,黄文湧,杨敬源,等.老年人轻度认知功能损害与Apo E基因多态性关系[J].中国公共卫生,2011,27(7):836-838.
[20] Petersen RC. Mild cognitive impairment:transition between aging and Alzheimer`s disease[J]. Neurologia,2000,15(3):93-101.
[21] Petersen RC. Mild cognitive impairment: current research and clinical implications[J]. Semin Neurol,2007,27(1):22-31.
[22] 周晓辉,朱晓琼,库木斯·巴雅合买提,等.新疆维吾尔族和汉族老年人轻度认知功能障碍的现况调查[J].中华老年医学杂志,2009,28(10):865-869.
[23] Souza DR,de Godoy MR,Hotta J,et al.Association of apolipoprotein E polymorphism in late-onset Alzheimer`s disease and vascular dementia in Brazilians[J].Braz J Med Biol Res,2003, 36(7):919-923.
[24] 马菲,王婷,银炯,等.社区老年人轻度认知功能障碍影响因素病例对照研究[J].中华流行病学杂志,2008,29(9):873-877.
[25] Traykov L,Rigaud AS,Baudic S,et al. Apolipoprotein E 4 allele frequency in demented and cognitively impaired patients with and with out cerebrovascular disease[J] . Neurol Sci,2002,3(4) :177-181.
[26] Machulda MM, Ward HA, Borowski B, et al. Comparison of memory fMRI response among normal, MCI, and Alzheimers′ patients[J]. Neurology, 2003, 61 (4) :500-506.
[27] 张耀东,徐勇,聂宏伟,等.中国人群阿尔茨海默病载脂蛋白E基因多态性的Meta分析[J].中国循证医学杂志,2011,11(4):433-436.
[28] Saunders AM,Strittmatter WJ,Schmechel D,et al.Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer's disease[J]. Neurology,1993,43(8):1467-1472.
[29] Borenstein AR, Mortimer JA, Ding Ding,et al. Effects of apolipoprotein E- epsilon4 and - epsilon2 in amnestic mild cognitive impairment and dementia in Shanghai: SCOBHI- P[J]. Am J Alzheimers Dis Other Demen, 2010, 25(3): 233-238.