1
|
Suchy-Dicey A, Howard B, Longstreth WT, Reiman EM, Buchwald D. APOE genotype, hippocampus, and cognitive markers of Alzheimer's disease in American Indians: Data from the Strong Heart Study. Alzheimers Dement 2022; 18:2518-2526. [PMID: 35142437 PMCID: PMC9363523 DOI: 10.1002/alz.12573] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/01/2021] [Accepted: 12/10/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND The apolipoprotein E (APOE) ε4 allele confers higher risk of neurodegeneration and Alzheimer's disease (AD), but differs by race/ethnicity. We examined this association in American Indians. METHODS The Strong Heart Study is a population-based cohort of American Indians who were 64 to 95 years of age in 2010 to 2013. APOE ε4 status, brain imaging, and neuropsychological testing was collected in N = 811 individuals. Summary statistics, graphics, and generalized linear regressions-adjusted for sociodemographics, clinical features, and intracranial volume with bootstrap variance estimator-compared APOE ε4 carriers with non-carriers. RESULTS APOE ε4 carriers comprised 22% of the population (0.7% homozygotes). Participants were mean 73 years, 67% female, and 54% had some college education. The majority were obese (>50%), hypertensive (>80%), and diabetic (>50%). Neither imaging findings nor multidomain cognitive testing showed any substantive differences between APOE ε4 carriers and non-carriers. CONCLUSION We found no evidence of neurodegenerative risk from APOE ε4 in American Indians. Additional studies are needed to examine potential protective features.
Collapse
Affiliation(s)
- Astrid Suchy-Dicey
- Washington State University Elson S Floyd College of Medicine, Seattle, Washington, USA
| | - Barbara Howard
- MedStar Health Research Institute, Phoenix, Arizona, USA
| | - W T Longstreth
- University of Washington Neurology and Epidemiology Departments, Seattle, Washington, USA
| | | | - Dedra Buchwald
- Washington State University Elson S Floyd College of Medicine, Seattle, Washington, USA
| |
Collapse
|
2
|
Lavrencic LM, Delbaere K, Broe GA, Daylight G, Draper B, Cumming RG, Garvey G, Allan W, Hill TY, Lasschuit D, Schofield PR, Radford K. Dementia Incidence, APOE Genotype, and Risk Factors for Cognitive Decline in Aboriginal Australians: A Longitudinal Cohort Study. Neurology 2022; 98:e1124-e1136. [PMID: 35140131 DOI: 10.1212/wnl.0000000000013295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/17/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Aboriginal Australians are disproportionately affected by dementia, with incidence in remote populations approximately double non-Indigenous populations. This study aimed to identify dementia incidence and risk factors in Aboriginal Australians residing in urban areas, which are currently unknown. METHODS A population-based cohort of Aboriginal Australians aged 60+ was assessed at baseline and 6-year follow-up. Life-course risk factors (baseline) were examined for incident dementia or mild cognitive impairment (MCI) using logistic regression analyses; adjustments were made for age. APOE genotyping was available for 86 people. RESULTS Data were included from 155 participants aged 60-86 years (mean=65.70, SD=5.65; 59 male). There were 16 incident dementia cases (age-standardised rate 35.97/1,000 person-years, 95% CI 18.34-53.60); and 36 combined incident MCI and dementia cases. Older age (OR 2.29, 1.42-3.70), male sex (OR 4.14, 1.60-10.77), unskilled work history (OR 5.09, 1.95-13.26), polypharmacy (OR 3.11, 1.17-8.28), and past smoking (OR 0.24, 0.08-0.75) were associated with incident MCI/dementia in the final model. APOE ε4 allele frequency was 24%; heterozygous or homozygous ε4 was associated with incident MCI/dementia (bivariate OR 3.96, 1.25-12.50). DISCUSSION These findings provide the first evidence for higher dementia incidence in Aboriginal Australians from urban areas, where the majority of Aboriginal people reside. This study also sheds light on sociodemographic, health and genetic factors associated with incident MCI/dementia at older ages in this population, which is critical for targeted prevention strategies.
Collapse
Affiliation(s)
- Louise M Lavrencic
- Neuroscience Research Australia, Randwick, NSW, Australia 2031 .,University of New South Wales, Sydney, NSW, Australia 2052.,Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia 2052
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, NSW, Australia 2031.,University of New South Wales, Sydney, NSW, Australia 2052.,Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia 2052
| | - Gerald A Broe
- Neuroscience Research Australia, Randwick, NSW, Australia 2031.,University of New South Wales, Sydney, NSW, Australia 2052.,Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia 2052
| | - Gail Daylight
- Neuroscience Research Australia, Randwick, NSW, Australia 2031
| | - Brian Draper
- University of New South Wales, Sydney, NSW, Australia 2052.,Prince of Wales Hospital, Randwick, NSW, Australia 2031
| | - Robert G Cumming
- School of Public Health, University of Sydney, Camperdown, NSW, Australia 2006
| | - Gail Garvey
- Menzies School of Health Research, Brisbane, QLD, Australia 4000
| | - Wendy Allan
- Neuroscience Research Australia, Randwick, NSW, Australia 2031
| | - Thi Yen Hill
- Neuroscience Research Australia, Randwick, NSW, Australia 2031.,Prince of Wales Hospital, Randwick, NSW, Australia 2031
| | - Danielle Lasschuit
- Neuroscience Research Australia, Randwick, NSW, Australia 2031.,Prince of Wales Hospital, Randwick, NSW, Australia 2031
| | - Peter R Schofield
- Neuroscience Research Australia, Randwick, NSW, Australia 2031.,University of New South Wales, Sydney, NSW, Australia 2052
| | - Kylie Radford
- Neuroscience Research Australia, Randwick, NSW, Australia 2031.,University of New South Wales, Sydney, NSW, Australia 2052.,Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia 2052
| |
Collapse
|
3
|
Juonala M, Sjöholm P, Pahkala K, Ellul S, Kartiosuo N, Davison B, Singh GR. The Australian Aboriginal Birth Cohort study: socio-economic status at birth and cardiovascular risk factors to 25 years of age. Med J Aust 2019; 211:265-270. [PMID: 31329333 DOI: 10.5694/mja2.50285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine whether socio-economic status at birth is associated with differences in risk factors for cardiovascular disease - body mass index (BMI), blood pressure, blood lipid levels - during the first 25 years of life. DESIGN Analysis of prospectively collected data. SETTING, PARTICIPANTS 570 of 686 children born to Aboriginal mothers at the Royal Darwin Hospital during 1987-1990 and recruited for the Aboriginal Birth Cohort Study in the Northern Territory. Participants resided in 46 urban and remote communities across the NT. The analysed data were collected at three follow-ups: Wave 2 in 1998-2001 (570 participants; mean age, 11 years), Wave 3 in 2006-2008 (442 participants; mean age, 18 years), and Wave 4 in 2014-2016 (423 participants; mean age, 25 years). MAIN OUTCOME MEASURES Cardiovascular disease risk factors by study wave and three socio-economic measures at the time of birth: area-level Indigenous Relative Socioeconomic Outcomes (IRSEO) index score and location (urban, remote) of residence, and parity of mother. RESULTS Area-level IRSEO of residence at birth influenced BMI (P < 0.001), systolic blood pressure (P = 0.024), LDL-cholesterol (P = 0.010), and HDL-cholesterol levels (P < 0.001). Remoteness of residence at birth influenced BMI (P < 0.001), HDL-cholesterol (P < 0.001), and triglyceride levels (P = 0.043). Mother's parity at birth influenced BMI (P = 0.039). CONCLUSIONS Our longitudinal life course analyses indicate that area-level socio-economic factors at birth influence the prevalence of major cardiovascular disease risk factors among Indigenous Australians during childhood and early adulthood.
Collapse
Affiliation(s)
- Markus Juonala
- Turun Yliopisto (University of Turku), Turku, Finland.,Turku University Hospital, Turku, Finland.,Murdoch Children's Research Institute, Melbourne, VIC
| | | | - Katja Pahkala
- Turun Yliopisto (University of Turku), Turku, Finland
| | - Susan Ellul
- Murdoch Children's Research Institute, Melbourne, VIC
| | - Noora Kartiosuo
- Research Centre of Applied and Preventive Cardiovascular Medicine, Turun Yliopisto, Turku, Finland
| | | | | |
Collapse
|
4
|
Tácito LHB, Yamada LN, de Souza Pinhel MA, Yugar-Toledo JC, Souza DRS. Influence of Apolipoprotein E on the Lipid Profile and Postprandial Triglyceride Levels in Brazilian Postmenopausal Women With Artery Disease. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2017; 11:1179546817731110. [PMID: 28974920 PMCID: PMC5613840 DOI: 10.1177/1179546817731110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/22/2017] [Indexed: 11/16/2022]
Abstract
This study confirms the association of risk factors for coronary artery disease (CAD) and the apoE polymorphisms, specifically related to the APOE*4 allele, with coronary disease in postmenopausal women. Significantly altered values of the lipid profile were found in patients when compared with controls, independent of the presence of the APOE*4 allele. However, the controls showed higher high-density lipoprotein cholesterol (HDL-C) levels and reduced triglyceride (TG) levels, differing significantly from patients. In this case, the study of subgroups, considering the APOE*3/3 and APOE*3/4 genotypes, suggests that the APOE*4 allele is not implicated in the variations of the lipid profile of patients and determined an increase in the production levels of HDL-C and a reduction in TG highly benefiting the control group compared with APOE*3/3 genotype. The metabolic kinetics of TG, although with the same pattern between groups, and the presence of the APOE*4 allele are suggested to be associated with accelerated clearance compared with APOE*3 allele in non-CAD group.
Collapse
Affiliation(s)
- Lúcia Helena Bonalume Tácito
- Endocrinology Division, Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Lilian Nakachima Yamada
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Marcela Augusta de Souza Pinhel
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Juan Carlos Yugar-Toledo
- Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Dorotéia Rossi Silva Souza
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| |
Collapse
|
5
|
Iyngkaran P, Thomas MC, Johnson R, French J, Ilton M, McDonald P, Hare DL, Fatkin D. Contextualizing Genetics for Regional Heart Failure Care. Curr Cardiol Rev 2016; 12:231-42. [PMID: 27280306 PMCID: PMC5011192 DOI: 10.2174/1573403x12666160606123103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/18/2015] [Accepted: 01/11/2016] [Indexed: 12/21/2022] Open
Abstract
Congestive heart failure (CHF) is a chronic and often devastating cardiovascular disorder with no cure. There has been much advancement in the last two decades that has seen improvements in morbidity and mortality. Clinicians have also noted variations in the responses to therapies. More detailed observations also point to clusters of diseases, phenotypic groupings, unusual severity and the rates at which CHF occurs. Medical genetics is playing an increasingly important role in answering some of these observations. This developing field in many respects provides more information than is currently clinically applicable. This includes making sense of the established single gene mutations or uncommon private mutations. In this thematic series which discusses the many factors that could be relevant for CHF care, once established treatments are available in the communities; this section addresses a contextual role for medical genetics.
Collapse
|
7
|
Lyons JG, O'Dea K, Walker KZ. Evidence for low high-density lipoprotein cholesterol levels in Australian indigenous peoples: a systematic review. BMC Public Health 2014; 14:545. [PMID: 24888391 PMCID: PMC4067101 DOI: 10.1186/1471-2458-14-545] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 05/23/2014] [Indexed: 12/15/2022] Open
Abstract
Background Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia’s Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C. Methods PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: <1.0 mmol/L. Analyses of primary data associating measures of HDL-C with other CVD risk factors were also performed. Results Fifteen of 93 retrieved studies were identified for inclusion. These provided 58 mean HDL-C levels; 29 for each sex, most obtained in rural/regional (20%) or remote settings (60%) and including 51–1641 participants. For Australian Aborigines, mean HDL-C values ranged between 0.81-1.50 mmol/L in females and 0.76-1.60 mmol/L in males. Two of 15 studies reported HDL-C levels for Torres Strait Islander populations, mean HDL-C: 1.00 or 1.11 mmol/L for females and 1.01 or 1.13 mmol/L for males. Low HDL-C was observed only in rural/regional and remote settings - not in national or urban studies (n = 3) in either gender. Diabetes prevalence, mean/median waist-to-hip ratio and circulating C-reactive protein levels were negatively associated with HDL-C levels (all P < 0.05). Thirty-four per cent of studies reported lower mean HDL-C levels in females than in males. Conclusions Very low mean HDL-C levels are common in Australian Indigenous populations living in rural and remote communities. Inverse associations between HDL-C and central obesity, diabetes prevalence and inflammatory markers suggest a particularly adverse CVD risk factor profile. An absence of sex dichotomy in HDL-C levels warrants further investigation.
Collapse
Affiliation(s)
- Jasmine G Lyons
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia.
| | | | | |
Collapse
|
8
|
Laws SM, Hone E, Gandy S, Martins RN. Expanding the association between the APOE gene and the risk of Alzheimer's disease: possible roles for APOE promoter polymorphisms and alterations in APOE transcription. J Neurochem 2003; 84:1215-36. [PMID: 12614323 DOI: 10.1046/j.1471-4159.2003.01615.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Alzheimer's disease (AD) is the most commonly diagnosed form of dementia in the elderly. Predominantly this disease is sporadic in nature with only a small percentage of patients exhibiting a familial trait. Early-onset AD may be explained by single gene defects; however, most AD cases are late onset (> 65 years) and, although there is no known definite cause for this form of the disease, there are several known risk factors. Of these, the epsilon4 allele of the apolipoprotein E (apoE) gene (APOE) is a major risk factor. The epsilon4 allele of APOE is one of three (epsilon2 epsilon3 and epsilon4) common alleles generated by cysteine/arginine substitutions at two polymorphic sites. The possession of the epsilon 4 allele is recognized as the most common identifiable genetic risk factor for late-onset AD across most populations. Unlike the pathogenic mutations in the amyloid precursor or those in the presenilins, APOE epsilon4 alleles increase the risk for AD but do not guarantee disease, even when present in homozygosity. In addition to the cysteine/arginine polymorphisms at the epsilon2/epsilon3/epsilon4 locus, polymorphisms within the proximal promoter of the APOE gene may lead to increased apoE levels by altering transcription of the APOE gene. Here we review the genetic and biochemical evidence supporting the hypothesis that regulation of apoE protein levels may contribute to the risk of AD, distinct from the well known polymorphisms at the epsilon2/epsilon3/epsilon4 locus.
Collapse
Affiliation(s)
- Simon M Laws
- Sir James McCusker Alzheimer's Disease Research Unit, School of Psychiatry and Neuroscience, University of Western Australia, Hollywood Private Hospital, Perth, Western Australia, Australia
| | | | | | | |
Collapse
|
9
|
Ashavaid TF, Todur SP, Nair KG. Apolipoprotein E4 polymorphism as risk factor for coronary heart disease among Indian subjects. Indian J Clin Biochem 2002; 17:83-93. [PMID: 23105342 PMCID: PMC3453726 DOI: 10.1007/bf02867947] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Apolipoprotein E genotypes and lipid and lipoprotein levels were determined in hypercholesterolemic and angiographically vertified CHD subjects and compared against 90 normolipidemic controls. The ε4 allele was significantly prevalent in the hypercholesterolemic and CHD subjects. Significant increase in total cholesterol levels in apo ε4 containing subjects were observed in the hypercholesterolemic and CHD group. The study suggests that the ε4 allele by influencing the lipid levels could act as a risk factor for CHD.
Collapse
Affiliation(s)
- Tester F. Ashavaid
- Research Laboratories, P.D. Hinduja National Hospital & Medical Research Centre, Veer Savarkar Marg, Mahim, 400 016 Mumbai, India
| | - Seema P. Todur
- Research Laboratories, P.D. Hinduja National Hospital & Medical Research Centre, Veer Savarkar Marg, Mahim, 400 016 Mumbai, India
| | - Kappiareth G. Nair
- Research Laboratories, P.D. Hinduja National Hospital & Medical Research Centre, Veer Savarkar Marg, Mahim, 400 016 Mumbai, India
| |
Collapse
|