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Glass DJ, Arnold SE. Some evolutionary perspectives on Alzheimer's disease pathogenesis and pathology. Alzheimers Dement 2011; 8:343-51. [PMID: 22137143 DOI: 10.1016/j.jalz.2011.05.2408] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 02/20/2011] [Accepted: 05/12/2011] [Indexed: 10/14/2022]
Abstract
There is increasing urgency to develop effective prevention and treatment for Alzheimer's disease (AD) as the aging population swells. Yet, our understanding remains limited for the elemental pathophysiological mechanisms of AD dementia that may be causal, compensatory, or epiphenomenal. To this end, we consider AD and why it exists from the perspectives of natural selection, adaptation, genetic drift, and other evolutionary forces. We discuss the connection between the apolipoprotein E (APOE) allele and AD, with special consideration to APOE ɛ4 as the ancestral allele. The phylogeny of AD-like changes across species is also examined, and pathology and treatment implications of AD are discussed from the perspective of evolutionary medicine. In particular, amyloid-β (Aβ) neuritic plaques and paired helical filament tau (PHFtau) neurofibrillary tangles have been traditionally viewed as injurious pathologies to be targeted, but may be preservative or restorative processes that mitigate harmful neurodegenerative processes or may be epiphenoma of the essential processes that cause neurodegeneration. Thus, we raise fundamental questions about current strategies for AD prevention and therapeutics.
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Affiliation(s)
- Daniel J Glass
- Department of Psychology, State University of New York at New Paltz, USA
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Guangda X, Linshuang Z, Jie H, Ling Y, Huijuan X. Apo e4 allele is associated with endothelium-dependent arterial dilation in women with type 2 diabetes. Diabetes Res Clin Pract 2006; 72:155-61. [PMID: 16337304 DOI: 10.1016/j.diabres.2005.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2005] [Accepted: 10/07/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Previous studies have suggested that the e4 allele of apolipoprotein E (apo E) relates to the endothelium-dependent arterial dilation in men with type 2 diabetes. This study attempted to assess whether apo e4 allele is associated with endothelial dysfunction in women with type 2 diabetes. RESEARCH DESIGN AND METHODS We selected 144 Chinese Han female type 2 diabetic patients without clinically detectable angiopathy. Polymerase chain reaction/ASO probes were used to determine their mouthwash DNA apo E genotypes, and high-resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia (with increased flow causing endothelium-dependent dilation) and after sublingual glyceryltrinitrate (GTN, an endothelium-independent dilator). RESULTS The flow-mediated arterial dilation among the subjects with e4/3 or e4/4 was 3.56+/-0.23%, which was significantly lower than that in subjects with e2/2 or e3/2 (3.97+/-0.36%) (p=0.000). The baseline vessel size, GTN-induced dilation and baseline blood flows were not significantly different among different apo E genotypes. On univariate analysis, reduced flow-mediated arterial dilation was significantly related to total cholesterol, LDL, Lp(a), high blood pressure, older age, family history of premature vascular disease, larger vessel size, duration of diabetes and e4 allele (p<0.05). By multiple stepwise regression analysis, reduced flow-mediated arterial dilation was associated with older age, large vessel size, duration of diabetes, positive family history, LDL, Lp(a) and e4 allele (p<0.01). CONCLUSION The apo e4 allele is associated with impairment of endothelium-dependent arterial dilation in the relatively early stage of female type 2 diabetes.
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Affiliation(s)
- Xiang Guangda
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, PR China.
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Cerrato P, Baima C, Grasso M, Lentini A, Bosco G, Cassader M, Gambino R, Cavallo Perin P, Pagano G, Fornengo P, Imperiale D, Bergamasco B, Bruno G. Apolipoprotein E Polymorphism and Stroke Subtypes in an Italian Cohort. Cerebrovasc Dis 2005; 20:264-9. [PMID: 16123547 DOI: 10.1159/000087709] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2004] [Accepted: 06/07/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies have indicated that apolipoprotein E (ApoE)-epsilon4 is a risk factor for ischemic cerebrovascular diseases (ICVD), but the existence of this association is still controversial. The aims of this study were: (1) to compare ApoE genotype and allele frequencies in Italian cases with ICVD and in healthy control subjects and (2) to compare ApoE allele frequencies among ischemic stroke subtypes. METHODS A hospital-based cohort of 302 Italian subjects with ICVD and 228 healthy subjects have been recruited to investigate the role of ApoE polymorphisms as risk factors for ICVD. TOAST criteria were employed to stratify ICVD cases by subtypes. RESULTS No significant differences in ApoE genotype and allele frequencies were found between cases and control subjects. The frequency of ApoE-epsilon4 was lower in cases than in control subjects (6% vs. 10.1%), although not significantly. No differences in ApoE genotype and allele frequencies were evident among ICVD subtypes. However, out of 36 ApoE-epsilon4 alleles 23 (3.7%) were found in subjects with ICVD related to primary degenerative arterial disease related to large vessel disease and small vessel disease, and 13 (2.1%) in remaining subjects. Using logistic regression analysis we assessed whether ApoE-epsilon4 allele was independently associated with risk of ICVD related to a primary degenerative arterial disease compared to other ICVD subtypes. While classical risk factors were significantly associated with higher risk for ICVD due to large vessel disease and small vessel disease than other ICVD subtypes, the role of ApoE-epsilon4 allele was not significant (OR 1.25, 95% CI 0.57-2.74). CONCLUSION Our study shows similar ApoE-epsilon4 genotype and allele frequencies in patients with ICVD and in control subjects. No differences were found among different ICVD subtypes either.
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Affiliation(s)
- P Cerrato
- Department of Neuroscience, University of Turin, Turin, Italy.
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Guang-da X, Xiang-Jiu Y, Lin-Shuang Z, Zhi-Song C, Yu-Sheng H. Apolipoprotein e4 allele and the risk of CAD death in type 2 diabetes mellitus with ischaemia electrocardiographic change. Diabetes Res Clin Pract 2005; 68:223-9. [PMID: 15936464 DOI: 10.1016/j.diabres.2004.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2003] [Revised: 08/13/2004] [Accepted: 09/06/2004] [Indexed: 10/26/2022]
Abstract
The presence of apolipoprotein (Apo) e4 allele is reported to be associated with the increased risk of coronary artery disease (CAD), as well as the impairment of endothelium-dependent arterial dilation in type 2 diabetes mellitus. Therefore, we hypothesized that Apo e4 allele increases the death risk from coronary artery disease in type 2 diabetes with ischaemia electrocardiographic change. From January 1993 to December 1999, 46 type 2 diabetic patients with e4/4 or e4/3, 96 with e3/3 and 45 with e2/2 or e3/2 genotypes were recruited. All subjects were unrelated elderly type 2 diabetic patients with ischaemia electrocardiographic change, aged 60-87 years, and their cardiac function were all the class I stage at their time of enrollment. A follow-up study of 3-10 years was undergone. The results are as follows: At baseline, serum total cholesterol and low-density lipoprotein (LDL) cholesterol concentrations were higher in subjects with e4/3 or e4/4 than in subjects with e2/2 or e3/2 (p<0.05). Lipoprotein(a) concentration was lower in subjects with e2/2 or e3/2 than in subjects with e3/3 and e4/3 or e4/4 (p < 0.05). During the 3-10 years follow-up period, a total of 55 patients who died from CAD were recorded in this sample. Compared with patients with e3/3 (p = 0.024) and patients with e2/2 or e2/3 genotypes (p = 0.002), the mortality rate of CAD in patients with e4/3 or e4/4 genotypes was the highest (47.8%). Stepwise discriminant analysis revealed that in the diabetic population studied Apo e4 allele was independently and significantly associated with CAD death (B = 0.65). However, the strength of the association decreased (B = 0.44) when total cholesterol, LDL-cholesterol and lipoprotein(a) were included in the model. Therefore, we concluded that Apo e4 allele increases the risk of CAD death in elderly type 2 diabetes mellitus with ischaemia electrocardiographic change.
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Affiliation(s)
- Xiang Guang-da
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command of PLA, Wuhan 430070, PR China.
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Guang-da X, You-ying L, Zhi-song C, Yu-sheng H, Xiang-jiu Y. Apolipoprotein e4 allele is predictor of coronary artery disease death in elderly patients with type 2 diabetes mellitus. Atherosclerosis 2004; 175:77-81. [PMID: 15186949 DOI: 10.1016/j.atherosclerosis.2004.02.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Accepted: 02/27/2004] [Indexed: 10/26/2022]
Abstract
The presence of the apolipoprotein (Apo) e4 allele is reported to be associated with the increased risk of coronary artery disease (CAD), as well as the impairment of endothelium-dependent dilation in type 2 diabetes mellitus. Therefore, we hypothesized that the Apo e4 allele increases the death risk from coronary artery disease in type 2 diabetes. From January 1993 to December 1999, 36 type 2 diabetic patients with e4/4 or e4/3, 62 with e3/3 and 33 with e2/2 or e3/2 genotypes were recruited. All subjects were unrelated, elderly, type 2 diabetic patients with coronary artery disease, aged 60-84 years, with cardiac function at the Class I stage at time of enrollment. A follow-up study of 3-10 years was undergone. The results are as follows: At baseline, serum total cholesterol and low density lipoprotein (LDL) cholesterol concentrations were higher in subjects with e4/3 or e4/4 than in subjects with e2/2 or e3/2 (P = 0.026). Lipoprotein(a) concentration was lower in subjects with e2/2 or e3/2 than in subjects with e3/3 (P = 0.044) and e4/3 or e4/4 (P = 0.038). During the 3-10 years follow-up period, a total of 39 patients who died from CAD was recorded in this sample. Compared with patients with e3/3 (P = 0.030) and patients with e2/2 or e3/2 genotypes (P = 0.001), the mortality rate of CAD in patients with e4/3 or e4/4 genotypes was the highest (50%). Stepwise discriminant analysis revealed that in the diabetic population studied the Apo e4 allele was independently and significantly associated with CAD death (B = 0.64). However, the strength of the association decreased (B = 0.48) when total cholesterol, LDL-cholesterol and lipoprotein(a) were included in the model. Therefore, we concluded that Apo e4 allele increases the risk of CAD death in elderly patients with type 2 diabetes mellitus.
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Affiliation(s)
- Xiang Guang-da
- The Department of Endocrinology, Guangzhou Command Wuhan General Hospital of PLA, Wuhan 430070, PR China.
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Finch CE, Stanford CB. Meat‐Adaptive Genes and the Evolution of Slower Aging in Humans. QUARTERLY REVIEW OF BIOLOGY 2004; 79:3-50. [PMID: 15101252 DOI: 10.1086/381662] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The chimpanzee life span is shorter than that of humans, which is consistent with a faster schedule of aging. We consider aspects of diet that may have selected for genes that allowed the evolution of longer human life spans with slower aging. Diet has changed remarkably during human evolution. All direct human ancestors are believed to have been largely herbivorous. Chimpanzees eat more meat than other great apes, but in captivity are sensitive to hypercholesterolemia and vascular disease. We argue that this dietary shift to increased regular consumption of fatty animal tissues in the course of hominid evolution was mediated by selection for "meat-adaptive" genes. This selection conferred resistance to disease risks associated with meat eating also increased life expectancy. One candidate gene is apolipoprotein E (apoE), with the E3 allele evolved in the genus Homo that reduces the risks for Alzheimer's and vascular disease, as well as influencing inflammation, infection, and neuronal growth. Other evolved genes mediate lipid metabolism and host defense. The timing of the evolution of apoE and other candidates for meat-adaptive genes is discussed in relation to key events in human evolution.
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Affiliation(s)
- Caleb E Finch
- Andrus Gerontology Center, Department of Biological Sciences, University of Southern California, Los Angeles, California 90089, USA.
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Guangda X, Yuhua W. Apolipoprotein e4 allele and endothelium-dependent arterial dilation in Type 2 diabetes mellitus without angiopathy. Diabetologia 2003; 46:514-9. [PMID: 12739024 DOI: 10.1007/s00125-003-1060-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2002] [Revised: 11/12/2002] [Indexed: 12/19/2022]
Abstract
AIMS/HYPOTHESIS Several studies have suggested a predisposing role of the e4 allele of apolipoprotein E (ApoE) in the development of atherosclerosis and cardiovascular disease in Type 2 diabetes. Therefore, we hypothesized that the e4 allele is also a risk factor for endothelial dysfunction. We attempted to assess whether Apo e4 allele is associated with endothelial dysfunction in the early stage of Type 2 diabetes. METHODS We selected 255 Chinese Han Type 2 diabtetic men without angiopathy. PCR or allele-specific oligonucleotide probes were used to analyse ApoE genotypes, and high resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperaemia and after sublingual glyceryltrinitrate. RESULTS The flow-mediated arterial dilation among the subjects with e4/3 or e4/4 was 3.14+/-0.32%, which was lower than that in subjects with e2/2 or e3/2 (4.04+/-0.30%) ( p=0.038). The baseline vessel size, glyceryltrinitrate-induced arterial dilation and baseline flow were not different among different ApoE genotypes. On univariate analysis, reduced flow-mediated arterial dilation was related to total cholesterol, LDL, lipoprotein(a) [Lp(a)], high blood pressure, older age, family history of premature vascular disease, larger vessel size, cigarette smoking, duration of diabetes and e4 allele ( p<0.05). By multiple stepwise regression analysis, reduced flow-mediated arterial dilation was associated with cigarette smoking, LDL, Lp(a), and e4 allele ( p<0.01). CONCLUSION/INTERPRETATION Apo e4 allele is associated with impairment of endothelium-dependent arterial dilation in the early stage of Type 2 diabetes.
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Affiliation(s)
- X Guangda
- Department of Endocrinology, Wuhan General Hospital, Wu Luo Road 627, 430070, Wuhan, People's Republic of China.
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Kalina A, Szalai C, Prohászka Z, Reiber I, Császár A. Association of plasma lipid levels with apolipoprotein E polymorphism in Type 2 diabetes. Diabetes Res Clin Pract 2002; 56:63-8. [PMID: 11879722 DOI: 10.1016/s0168-8227(01)00350-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the distribution of apolipoprotein E polymorphism in patients with Type 2 diabetes and their impact on plasma lipid levels. SUBJECTS Unrelated Type 2 diabetic patients (n = 298) treated by diet and sulfonylurea and not receiving lipid-lowering regimens, elderly (n = 98) and young (n = 101)unrelated healthy control subjects in Hungary. METHODS Apolipoprotein E genotypes were identified by PCR amplification and subsequent restriction endonuclease digestion. RESULTS The distribution of the most frequent genotypes in the diabetes group was E2/3 8.7%, E3/3 78.2%, E3/4 12.8%, in the elderly group E2/3 9.2%, E3/3 78.6%, E3/4 12.2% and in the young group E2/3 11.9%, E3/3 62.4%, E3/4 24.8%. The frequencies of allele e4 in the diabetes and in the elderly control group were significantly lower than in the young control group (both P < 0.05). Associations were found between the e4 allele and increased triglyceride level in the diabetes group, the e2 allele and decreased total cholesterol and LDL-cholesterol levels both in the elderly and young control groups (both P < 0.01). CONCLUSION The lower frequency of allele e4 in both the elderly and diabetes groups, may be explained by an increased morbidity and mortality in middle-aged carriers of apo e4 allele. The increased risk of e4 carriers in Type 2 diabetes may be partly mediated by a higher triglyceride level.
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Affiliation(s)
- Akos Kalina
- Cardiology Department of MAV Hospital, 1014 Budapest, Táncsics M. 20., Hungary.
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Tolosa M, Peiró S, Real JT, Cano A, Ascaso JF, Carmena R. The influence of apo E phenotypes on the plasma triglycerides response to hormonal replacement therapy during the menopause. Maturitas 2001; 40:173-81. [PMID: 11716996 DOI: 10.1016/s0378-5122(01)00237-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To study the influence of apo E phenotype in plasma lipids, especially in triglycerides levels, in menopausal women receiving hormonal replacement therapy (HRT). METHODS One hundred and ten postmenopausal women were studied. Plasma total cholesterol (TC), HDL-C and triglycerides (TG) were measured before and after 3 months of HRT and the apo E phenotype was determined. According to the apo E phenotype the sample was divided into three groups: E2/E3 (n=28), E3/E3 (n=96) and E4/E3 (n=25). RESULTS In the pre-treatment state, higher plasma levels of TC and TC/HDL-C ratio were observed in women with phenotype E3/E4 (P<0.0001 and P<0.02, respectively), while higher plasma TG levels were found in the apo E2/E3 group (P<0.0001). After HRT, women with phenotype E3/E4 showed higher levels of TC and TC/HDL-C ratio (P<0.0001 and P<0.006, respectively). The apo E2/E3 phenotype group showed increased levels of TG (P<0.0001). In the multivariant analysis the changes of TG after HRT were related to the type of treatment used (P<0.001), age (P=0.05) and the apo E phenotype (E2/E3). CONCLUSION Women with phenotype E2/E3 have higher plasma TG levels and show a significant post HRT increase compared with the other phenotypes. Other factors with a lower impact on TG levels are age and progestagen association.
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Affiliation(s)
- M Tolosa
- Endocrinology Services, Hospital Clínico Universitario, University of Valencia, Valencia, Spain
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Drabe N, Zünd G, Grünenfelder J, Sprenger M, Hoerstrup SP, Bestmann L, Maly FE, Turina M. Genetic predisposition in patients undergoing cardiopulmonary bypass surgery is associated with an increase of inflammatory cytokines. Eur J Cardiothorac Surg 2001; 20:609-13. [PMID: 11509287 DOI: 10.1016/s1010-7940(01)00842-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Cardiopulmonary bypass (CPB) surgery induces a transient rise in pro-inflammatory cytokines typically released by activated monocytes. The E4 variant of apolipoprotein E is a recognized risk factor for atherosclerosis. It has recently been shown that apolipoprotein E affects monocyte functions in vitro and leads to higher levels of median lipoprotein (a) in humans. The aim of the study is to investigate if the E4 genetic variant of apolipoprotein E affects cytokine release after CPB surgery. METHODS 22 patients were operated on with standard coronary artery bypass grafting. Concentrations of interleukin 8 (IL-8) and tumor necrosis factor (TNF-alpha) were measured by automated Immulite immunoassay at regular intervals within 48 h after surgery. Total apparent cytokine outputs were calculated as area under the curve. Results are expressed as mean+/-standard deviation and compared by unpaired t-test. RESULTS In the presented patient population 6 (27%) carried the E4 allele. Sixteen (63%) showed no E4 allele. Mean cross clamp time (CCT) was 56.2+/-13.5 min versus 55.7+/-12.1 min and CPB time was 91.8+/-17.5 versus 93.5+/-15.7 min. No statistical difference between E4-carriers and E4 non-carriers regarding CCT and CPB was observed. The total amount of IL-8 and TNF-alpha was higher in patients carrying the E4 genetic variant of apolipoprotein E in comparison to E4 non-carriers (P<0.08, P<0.039). CONCLUSION The presence of the E4 allele is associated with increased release of IL-8 and TNF-alpha after CBP surgery. The preoperative determination of E4 in patients undergoing cardiac surgery may lead to additional perioperative measures for the treatment of an increased systemic inflammatory response.
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Affiliation(s)
- N Drabe
- Clinic for Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
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Sandberg G, Stewart W, Smialek J, Troncoso JC. The prevalence of the neuropathological lesions of Alzheimer's disease is independent of race and gender. Neurobiol Aging 2001; 22:169-75. [PMID: 11182466 DOI: 10.1016/s0197-4580(00)00236-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Senile plaques (SP) and neurofibrillary tangles (NFT) are the lesions characteristic of Alzheimer's disease (AD). In this study, we examined variation in the proportion of individuals who had these lesions by race, age, and gender in a series of 138 autopsies conducted at the Office of the Chief Medical Examiner of the State of Maryland between 1990 and 1998. Cases were selected on the bases of age between 40 to 79 years and non-natural manner of death, and included 73% males, 61% subjects < 65 years of age, and 42% African Americans. Observations were conducted on histologic sections of the hippocampus, entorhinal cortex, and inferior temporal cortex stained with silver (Hirano method) and immunostained for Abeta-amyloid. We found that SP and NFT are strongly associated with age. These lesions begin to appear in the early to late 40s, depending on the anatomic location, and become common in the 6th decade, preceding by one to two decades the age at which AD becomes clinically prevalent. No difference in the prevalence of SP or NFT was found by gender or between whites and African Americans. The latter is in contrast to epidemiologic studies that suggest AD is more prevalent in African Americans than in whites.
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Affiliation(s)
- G Sandberg
- Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC 20306, USA
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Güz G, Nurhan Ozdemir F, Sezer S, Işiklar I, Arat Z, Turan M, Haberal M. Effect of apolipoprotein E polymorphism on serum lipid, lipoproteins, and atherosclerosis in hemodialysis patients. Am J Kidney Dis 2000; 36:826-36. [PMID: 11007687 DOI: 10.1053/ajkd.2000.17682] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Atherosclerosis and cardiovascular disease are the main causes of death in hemodialysis patients. Possession of the apolipoprotein E4 (ApoE4) allele has been associated with increased levels of serum lipids and with coronary and carotid artery atherosclerosis. We investigated the possible relationship between ApoE polymorphism and atherosclerosis risk factors in hemodialysis patients. Two hundred sixty-nine hemodialysis patients (115 women, 154 men) were included in our study. The mean patient age and mean hemodialysis duration were 45.8 +/- 15.3 years and 52.6 +/- 40.6 months, respectively. Testing was done on all patients to determine ApoE genotype and serum levels of total cholesterol (T-Cho), low-density lipoprotein (LDL-C), high-density cholesterol (HDL-C), triglyceride (TG), lipoprotein (a) (Lp[a]), intact parathormone (iPTH), and fibrinogen. ApoE genotype was identified with the polymerase chain reaction. Ultrasonographic measurement of carotid artery intima media thickness (IMT) was used to diagnose atherosclerosis. We also analyzed ApoE polymorphism and risk factors such as age, gender, duration of hemodialysis, smoking, and hypertension in relation to the presence of atherosclerosis. Serum T-Cho and LDL-C levels were higher in patients with the ApoE4/3 phenotype than in those with ApoE3/3 and ApoE3/2 phenotypes (P < 0.05). However, there was no statistically significant link between ApoE polymorphism and serum levels of TG, HDL-C, or Lp(a) (P > 0.05). Apart from a relationship with age and duration of hemodialysis (P < 0.05), we found no significant association between atherosclerosis and ApoE polymorphism or the other risk factors analyzed (P > 0.05). In conclusion, although ApoE polymorphism significantly affects serum levels of T-Cho and LDL-C in hemodialysis patients, this study indicates that ApoE polymorphism is not associated with the presence of atherosclerosis in these individuals. The high incidence of atherosclerosis in these patients underlines the need for further research on other possible causative factors.
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Affiliation(s)
- G Güz
- Departments of Nephrology and Immunology, and the Hemodialysis Unit, Baskent University Faculty of Medicine, Ankara, Turkey.
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Finch CE, Sapolsky RM. The evolution of Alzheimer disease, the reproductive schedule, and apoE isoforms. Neurobiol Aging 1999; 20:407-28. [PMID: 10604433 DOI: 10.1016/s0197-4580(99)00053-6] [Citation(s) in RCA: 138] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Alzheimer disease (AD)-like neuropathology increases progressively during aging in most primates, and, in some species, is concurrent with reproductive decline in females and cognitive impairments. We consider how the schedule of AD may have evolved in early humans in relation to the apolipoprotein E (apoE) allele system, which is not found in other primates, and to the increasing duration of postnatal care. The delay of independence and the increasing length of maturation required that the schedule of AD-like neurodegeneration be slowed, otherwise parental caregivers would already have become impaired. We hypothesize that the uniquely human apoE epsilon3 allele evolved from the epsilon4 of primate ancestors during human evolution in relation to the rapid increases of brain size and the emergence of grandmothering. In discussing theses possibilities, we review the diverse bioactivities of apoE, which include involvement in hormone systems. The evolution of menopause is also considered in relation to the protective effect of estrogen on AD.
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Affiliation(s)
- C E Finch
- Neurogerontology Division, Andrus Gerontology Center and University of Southern California, Los Angeles 90089-0191, USA.
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Myhrer T. Adverse psychological impact, glutamatergic dysfunction, and risk factors for Alzheimer's disease. Neurosci Biobehav Rev 1998; 23:131-9. [PMID: 9861617 DOI: 10.1016/s0149-7634(98)00039-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by cell loss and pathological changes in neuronal transmission. In particular, malfunction in glutamatergic activity may be associated with the impairment of memory seen in Alzheimer patients. Both hypoactivation and hyperactivation of glutamatergic systems seem to cause impeded cognitive processing in animals. Rats subjected to rearing in isolation display reduced levels of glutamate in temporal regions accompanied by impaired learning and memory. Similar cognitive deficits are also seen in animals exposed to behavioral stress. Stress appears to have deleterious effects on cognition caused by glutamate neurotoxicity leading to attenuated synaptic activity. It is suggested that stress may represent a potential risk factor for AD. The known risk factors for AD (age, heredity, head trauma, low education, depression) may all be related to glutamatergic dysfunction. Some difficulties with pharmacological approaches based on glutamatergic agonists are discussed. It is suggested that optimal glutamate-mediated neurotransmission throughout life may prevent the occurrence of mental decline associated with AD.
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Affiliation(s)
- T Myhrer
- Norwegian Defence Research Establishment, Division for Environmental Toxicology, Kjeller, Norway
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van der Cammen TJ, Verschoor CJ, van Loon CP, van Harskamp F, de Koning I, Schudel WJ, Slooter AJ, Van Broeckhoven C, van Duijn CM. Risk of left ventricular dysfunction in patients with probable Alzheimer's disease with APOE*4 allele. J Am Geriatr Soc 1998; 46:962-7. [PMID: 9706883 DOI: 10.1111/j.1532-5415.1998.tb02749.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the association between the APOE genotype and cardiovascular disease in Alzheimer's disease (AD) patients. DESIGN Case register study of 100 consecutive referrals to a Memory Clinic where type of dementia and cardiovascular comorbidity were diagnosed and APOE genotype was determined. SETTING The Memory Clinic, University Hospital Rotterdam Dijkzigt. PARTICIPANTS One hundred Memory Clinic patients, 59 to 91 years of age, who attended the Memory Clinic in the period between January 1994 and March 1996. MEASUREMENTS Relative risk of cardiovascular morbidity in probable AD, based on clinical and ECG findings. RESULTS The diagnosis of probable AD was more frequent in APOE*4 allele-carrying AD patients. When comparing homozygotes for APOE*4 with homozygotes for APOE*3, a nine-fold increase in prevalence of cardiac ischemia on ECG was found in the former. When grouping parameters of left ventricular dysfunction, the prevalence was 7.2 (95% confidence interval 1.2-42.6) times greater in probable Alzheimer patients with APOE4/4. CONCLUSIONS In patients with probable AD, APOE*4 is associated with cardiac disease indicative of left ventricular dysfunction.
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Affiliation(s)
- T J van der Cammen
- Department of Internal Medicine I and Geriatric Medicine, Erasmus University Medical School, Rotterdam, The Netherlands
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16
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Sanllehy C, Casals E, Rodriguez-Villar C, Zambón D, Ojuel J, Ballesta AM, Ros E. Lack of interaction of apolipoprotein E phenotype with the lipoprotein response to lovastatin or gemfibrozil in patients with primary hypercholesterolemia. Metabolism 1998; 47:560-5. [PMID: 9591747 DOI: 10.1016/s0026-0495(98)90240-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The magnitude of serum lipid changes in response to hypolipidemic drugs varies considerably between individuals. These differences may be due to interactions between genetic and environmental factors that effect drug bioavailability or the capacity of the lipid-regulating enzyme and receptor targets to be affected. The apolipoprotein E (apoE) gene locus has been examined in this regard, but reports are conflicting on the effect of its variability on the response to hypolipidemic drugs. We investigated the effect of apoE polymorphism on the serum lipid response to the hepatic hydroxymethyl glutaryl coenzyme A (HMG CoA) reductase inhibitor lovastatin and the fibric acid derivative gemfibrozil. Lipoprotein changes were assessed after 12 weeks of therapy in 106 patients with primary hypercholesterolemia and combined hyperlipidemia treated with lovastastin and in 63 given gemfibrozil therapy. No significant effect of the apoE phenotypes E3/2, E3/3, or E4/3 on the heterogeneity of lipid responses to either drug was found.
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Affiliation(s)
- C Sanllehy
- Clinical Biochemistry Department, Nutrition and Dietetics Service, Hospital Clínic i Provincial, Barcelona, Spain
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17
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Katzel LI, Fleg JL, Busby-Whitehead MJ, Sorkin JD, Becker LC, Lakatta EG, Goldberg AP. Exercise-induced silent myocardial ischemia in master athletes. Am J Cardiol 1998; 81:261-5. [PMID: 9468064 DOI: 10.1016/s0002-9149(97)00898-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
High-physical activity levels are associated with reduced risk of symptomatic coronary artery disease (CAD). However, there are a number of reports of exercise-related sudden death and myocardial infarction in aerobically trained athletes. This study compared the prevalence of exercise-induced silent myocardial ischemia on maximum graded exercise tests with tomographic thallium scintigraphy in 70 master male athletes (63 +/- 6 years, mean +/- SD) (maximum aerobic capacity, VO2max >40 ml/kg/min) and in 85 healthy untrained men (61 +/- 7 years) with no history of CAD. The prevalence of silent ischemia (exercise-induced ST-segment depression on electrocardiogram and perfusion abnormalities on thallium scintigraphy) was similar in athletes and untrained men; 16% of the athletes (11 of 70) had silent ischemia compared with 21% of the untrained men (chi-square = 0.81, p = 0.36). No athletes had hyperlipidemia, systemic hypertension, or diabetes mellitus. However, the apolipoprotein E4 allele was present in 9 of the 11 athletes with silent ischemia compared with 2 of 32 athletes with normal exercise tests (chi-square = 24, p = 0.0001). These results suggest that older male athletes with the apolipoprotein E4 allele are at increased risk for the development of exercise-induced silent ischemia.
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Affiliation(s)
- L I Katzel
- Department of Medicine, University of Maryland School of Medicine and Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, 21201, USA
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18
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Ragogna F, Angeli A, Corazza S, Tettamanti C, Faggiotto A, Grassi A, Ruotolo G. Increased J774 macrophage cytotoxicity of late postprandial triglyceride-rich lipoproteins from normolipidemic young men expressing an apolipoprotein epsilon 4 allele. Atherosclerosis 1997; 132:157-63. [PMID: 9242961 DOI: 10.1016/s0021-9150(97)00082-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
It has been demonstrated that normolipidemic young men with apolipoprotein E4/3 phenotype have a prolonged postprandial clearance of triglyceride-rich lipoproteins following a high-fat diet. In the present study, we isolated fasting and postprandial (3 and 8 h) lipoprotein fraction from normolipidemic young men with E3/3 and E4/3 phenotypes and examined the in vitro cytotoxicity of these lipoproteins towards J774 macrophages. 8 h E4/3 very low density lipoprotein (VLDL) were significantly more cytotoxic than either 8 h E3/3 VLDL or fasting and 3 h E4/3 VLDL (lactate dehydrogenase (LDH) released: 161 +/- 21, 107 +/- 9, 88 +/- 16 and 101 +/- 12 I.U./l, respectively). Fasting E4/3 intermediate density lipoprotein (IDL) were also significantly more cytotoxic than either fasting E3/3 IDL or 3 h and 8 h E4/3 IDL (LDH released: 105 +/- 23, 60 +/- 9, 37 +/- 5 and 53 +/- 16 I.U./l, respectively), whereas either fasting or postprandial low density lipoprotein (LDL) and high density lipoprotein (HDL) samples did not show any difference in cytotoxicity between the two groups studied. 8 h E4/3 VLDL samples incubated with J774 macrophages had a lower esterified cholesterol (40 +/- 3 versus 52 +/- 3 micrograms), and higher triglyceride (783 +/- 133 versus 418 +/- 64 micrograms) and free fatty acid (FFA) (2.0 +/- 0.4 versus 0.9 +/- 0.1 microgram) content than fasting E4/3 VLDL. The increased macrophage cytotoxicity of late postprandial triglyceride-rich lipoproteins seems to be related to the FFA content of E4/3 VLDL.
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Affiliation(s)
- F Ragogna
- Istituto Scientifico H San Raffaele, University of Milan, Italy
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19
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Henry JA, Bolla M, Osmond C, Fall C, Barker DJ, Humphries SE. The effects of genotype and infant weight on adult plasma levels of fibrinogen, factor VII, and LDL cholesterol are additive. J Med Genet 1997; 34:553-8. [PMID: 9222962 PMCID: PMC1050994 DOI: 10.1136/jmg.34.7.553] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
High circulating levels of cholesterol, particularly low density lipoprotein (LDL) cholesterol and the clotting factors fibrinogen and factor VII, are associated with increased risk of myocardial infarction. Variations in the plasma levels of these factors are determined in part by polymorphisms in the genes concerned and also by weight at 1 year (infant weight). We have looked at the possibility of interactions between these genetic factors and infant weight in a sample of 290 men and 192 women from Hertfordshire using the beta-fibrinogen G/A-455, factor VII R353Q, and ApoE polymorphisms. The rare allele frequencies of the three polymorphisms were 0.19 for beta-fibrinogen, 0.10 for factor VII, and 0.07 and 0.13 for the 2 and 4 alleles of ApoE, and these frequencies were not different in subjects of different infant weight. In this sample, the polymorphisms showed the expected effects on plasma levels of fibrinogen, factor VII, and LDL cholesterol. The A-455 allele was associated with higher fibrinogen levels but the effect was only statistically significant in women (p = 0.003). The R353 allele was associated with higher factor VII activity in both men and women (p < 0.0001 for both). The ApoE2 allele was associated with lower levels of LDL cholesterol (p = 0.03 in men, p = 0.006 in women), while the ApoE4 allele was associated with higher levels (p < 0.001 in men, not significant in women). In this sample of men and women the effect of low infant weight was only associated with significant effects on fibrinogen and LDL cholesterol in the group of men (p = 0.005 and p = 0.008 respectively). Compared with the E3E3 subjects, the LDL lowering effect of the E2 allele and the raising effect of the E4 allele was greater in those with low infant weight compared with those with high infant weight (low v high infant weight for E2: 12.7% v 9.4%; for E4 12.7% v 8.5%). Although in this sample the interactive effect did not reach statistical significance, the additive effect of ApoE genotype and low infant weight on determining plasma LDL cholesterol levels, if confirmed, may be of relevance in determining a person's future risk of atherosclerosis.
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Affiliation(s)
- J A Henry
- Department of Medicine, UCL Medical School, Rayne Institute, London, UK
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20
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Dart A, Sherrard B, Simpson H. Influence of apo E phenotype on postprandial triglyceride and glucose responses in subjects with and without coronary heart disease. Atherosclerosis 1997; 130:161-70. [PMID: 9126660 DOI: 10.1016/s0021-9150(96)06062-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Apolipoprotein E phenotypes and fasting lipid and other biochemical parameters were determined in 51 patients with recently diagnosed coronary heart disease (CHD) and 164 control subjects. The age of the participants was 62.5 +/- 6.6 (S.D.) and 63% were male. Forty-eight CHD cases and 51 control subjects were also studied for 8 h after a fat-rich meal. Apo E phenotypes did not differ significantly between CHD cases and control subjects although there was a tendency for under-representation of E2/E3 in the cases (6% versus 16%). Fifteen CHD cases and 37 (of 164) control subjects had at least one epsilon 4 allele. Fasting plasma triglyceride concentrations were not different between CHD cases and controls but were significantly elevated in subjects with an epsilon 4 allele. CHD cases did, however, have a significantly elevated fasting insulin compared with controls. Postprandial triglyceride responses were not different between CHD cases and controls. However, postprandial triglyceride responses were elevated in subjects (CHD cases and controls) who had an epsilon 4 allele. In multivariate analysis, both epsilon 4 allele status and body mass index (BMI) were significant determinants of postprandial triglyceride responses. Postprandial glucose responses were also elevated in subjects with an epsilon 4 allele. When comparison of CHD cases and controls was restricted to those without an epsilon 4 allele, CHD cases showed a borderline significant (P = 0.05) difference in time course from controls, with a slower decline in plasma triglyceride from the peak response. Fasting and postprandial triglyceride and postprandial glucose responses are strongly dependent on the presence of an epsilon 4 allele. The elevation in postprandial triglyceride responses associated with an epsilon 4 allele can obscure differences associated with the presence of CHD and suggests that although elevated postprandial triglyceride response may be a risk factor for CHD, it is not the major reason for the association between the possession of an epsilon 4 allele and coronary disease.
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Affiliation(s)
- A Dart
- Alfred Baker Medical Unit, Alfred Hospital, Melbourne, Victoria, Australia
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21
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Kukull WA, Schellenberg GD, Bowen JD, McCormick WC, Yu CE, Teri L, Thompson JD, O'Meara ES, Larson EB. Apolipoprotein E in Alzheimer's disease risk and case detection: a case-control study. J Clin Epidemiol 1996; 49:1143-8. [PMID: 8826994 DOI: 10.1016/0895-4356(96)00195-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The objective of this study was to describe the association between the epsilon 4 allele of the apolipoprotein E gene (APOE E4) and Alzheimer's disease (AD) and to evaluate APOE E4 genotyping as a test for AD. The study base of this case-control study included about 23,000 persons 60 year of age or greater (a large health maintenance organization); the demographic characteristics of this group are similar to those of the surrounding area. Analysis focused on 234 Caucasian probable AD patients first identified between 1987 and 1993; and 304 cognitively intact controls of similar age, sex, and race who were randomly selected from the same study base. All cases were examined and diagnosed by study physicians using standard protocols. All subjects participate in continuing annual follow-up testing to verify their cognitive status. APOE genotypes were determined from blood samples using standard laboratory methods. Subject characteristics and diagnoses were obtained from interviews, diagnostic examination, or medical record review. Heterozygous E4 individuals had a crude odds ratio of 3.1 (2.1-4.5) for AD compared to those with no E4, while homozygous E4 subjects had an odds ratio of 34.3 (8.0-146.3) for AD. As an indicator of AD, having one E4 allele showed a sensitivity of 0.52 and a specificity of 0.74. Homozygous E4 genotype had a sensitivity of 0.23 and a specificity of 0.99 (when compared to non-E4 genotypes). Cardiovascular disease differed in cases and controls, but did not confound or modify the APOE E4-AI) association. In this study base, the APOE E4 allele was a significant risk factor. However, considering either homozygous or heterozygous E4 genotype as a screen or diagnostic marker for AD would miss many true cases and could misclassify many normals as AD.
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Affiliation(s)
- W A Kukull
- Department of Epidemiology, University of Washington, Seattle 98195, USA
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22
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Yamamoto H, Imazu M, Yamabe T, Ueda H, Hattori Y, Yamakido M. Risk factors for restenosis after percutaneous transluminal coronary angioplasty: role of lipoprotein (a). Am Heart J 1995; 130:1168-73. [PMID: 7484765 DOI: 10.1016/0002-8703(95)90138-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To evaluate serum levels of lipoprotein (a) (Lp[a]) as a predictor of restenosis after percutaneous transluminal coronary angioplasty (PTCA), we evaluated 71 patients who underwent elective single-vessel angioplasty. Patients were divided into two groups according to the presence (n = 24 [34%]; group R) or absence (n = 47 [66%]; group N) of restenosis. Serum insulin levels were similar before and after the glucose challenge test in both groups. The median level of serum Lp(a) was 34.9 mg/dl in group R compared with 19.4 mg/dl in group N (p < 0.01). The frequency of the apo E4 allele was 4 (17%) in group R and 4 (9%) in group N (p = NS). The incidence of restenosis was significantly higher in patients with Lp(a) levels > or = 30 mg/dl than in those with Lp(a) levels < 30 mg/dl (65% vs 26%; p < 0.01). Our results indicate that a serum Lp(a) level > or = 30 mg/dl is a risk factor for restenosis.
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Affiliation(s)
- H Yamamoto
- Second Department of Internal Medicine, Hiroshima University, School of Medicine, Japan
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23
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Damaraju S, Yu QT, Safavi F, Marian AJ. Apolipoprotein epsilon 4 is not a genetic risk factor for coronary artery disease or restenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol 1995; 75:1181-3. [PMID: 7762511 DOI: 10.1016/s0002-9149(99)80756-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S Damaraju
- Baylor College of Medicine, Department of Medicine, Houston, Texas, USA
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24
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Katzel LI, Sorkin KD, Colman E, Goldberg AP, Busby-Whitehead MJ, Lakatta LE, Becker LC, Lakatta EG, Fleg JL. Risk factors for exercise-induced silent myocardial ischemia in healthy volunteers. Am J Cardiol 1994; 74:869-74. [PMID: 7977116 DOI: 10.1016/0002-9149(94)90578-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study determined the risk factors for exercise-induced silent ischemia (SI) in 281 apparently healthy volunteers aged 40 to 87 years and compared their risk factor profiles with those of 132 patients with overt coronary artery disease (CAD). SI (concordant exercise-induced asymptomatic ST-segment depression on electrocardiography and perfusion defects on tomographic thallium-201 scintigraphy) was detected in 37 of 225 men (16%), versus 2 of 56 women (4%, p < 0.05). The prevalence of SI increased with age from 6% in men aged < 55 years to 18% in men aged 55 to 70 years, and to 25% in men aged > 70 years (p < 0.001). Compared with the 118 men with concordant normal exercise electrocardiogram and thallium scan (normals), men with SI were older (p < 0.001), and had a higher waist-to-hip ratio (p < 0.005), higher plasma triglyceride levels (p < 0.001), and lower high-density lipoprotein (HDL) cholesterol levels (p < 0.001). In stepwise logistic regression analysis, age, waist-to-hip ratio, and HDL levels were independent predictors of SI in men. Compared with 108 men with overt CAD, men with SI were younger (67 +/- 2 vs 73 +/- 1 years, p < 0.001) but had similar plasma lipids and waist-to-hip ratio. Thus, older age, male gender, abdominal obesity, and reduced HDL levels--all well-established risk factors for overt CAD--were risk factors for exercise-induced SI in these asymptomatic volunteers.
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Affiliation(s)
- L I Katzel
- Department of Medicine, University of Maryland School of Medicine, Baltimore
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25
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Abstract
The past year has seen widespread confirmation that the epsilon 4 allele of the apolipoprotein E gene is a major risk factor for Alzheimer's disease. The epsilon 4 allele also appears to correlate with life expectancy. This allele has been found to be present in over 50% of Alzheimer patients, regardless of whether or not they have a family history of dementia. It is not yet clear how the epsilon 4 allele mediates its actions; however, recent evidence suggests that apolipoprotein E4 may be responsible for the accelerated formation of beta-pleated amyloid from soluble beta-amyloid peptide, as is seen in the neuritic plaques of Alzheimer patients, as well as interacting with intraneuronal microtubular transport mechanisms.
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Affiliation(s)
- R Katzman
- Department of Neurosciences, School of Medicine, University of California San Diego, La Jolla 92093-0949
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