APOE4

apoE4
  • 文章类型: Journal Article
    APOE4被广泛认为是阿尔茨海默病(AD)的遗传危险因素,涉及所有AD病例的60-80%。最近的研究表明,携带APOE4基因型的小胶质细胞显示异常的脂质代谢和积累的脂滴,这可能会加剧AD的病理。小胶质细胞在中枢神经系统内的免疫监视中起关键作用,并且负责去除有害颗粒和保持神经元功能。APOE4基因型导致小胶质细胞脂质代谢异常,导致脂滴过度积累。这种积累不仅损害了小胶质细胞的吞噬和清除能力,而且破坏了它们与神经元的相互作用,导致神经元网络水平的混乱和神经退行性改变。此外,APOE4的存在改变了小胶质细胞的代谢景观,特别影响嘌呤能信号和脂质代谢,从而加剧AD的病理过程。总之,在携带APOE4基因型的小胶质细胞中,脂滴的积累和异常的脂质代谢可能是AD进展的关键机制。
    APOE4 is widely recognized as a genetic risk factor for Alzheimer\'s disease (AD), implicated in 60-80% of all AD cases. Recent research suggests that microglia carrying the APOE4 genotype display abnormal lipid metabolism and accumulate lipid droplets, which may exacerbate the pathology of AD. Microglia play a critical role in immune surveillance within the central nervous system and are responsible for removing harmful particles and preserving neuronal function. The APOE4 genotype causes abnormal lipid metabolism in microglia, resulting in excessive accumulation of lipid droplets. This accumulation not only impairs the phagocytic and clearance capabilities of microglia but also disrupts their interactions with neurons, resulting in disorganization and neurodegenerative alterations at the neuronal network level. In addition, the presence of APOE4 modifies the metabolic landscape of microglia, particularly affecting purinergic signaling and lipid metabolism, thereby exacerbating the pathological processes of AD. In conclusion, the accumulation of lipid droplets and abnormal lipid metabolism may be critical mechanisms in the progression of AD in microglia carrying the APOE4 genotype.
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  • 文章类型: Journal Article
    载脂蛋白E4(ApoE4)参与应激反应过程,并被认为是线粒体功能障碍导致抑郁症的危险因素。然而,它们的确切作用和潜在机制在很大程度上是未知的。ApoE4转基因小鼠(B6。Cg-ApoEtm1UncCdh18Tg(GFAP-APOEi4)1Hol/J)受到胁迫(脂多糖,LPS)以阐明ApoE4诱导的抑郁症的病因。LPS治疗显著加重抑郁样行为,同时伴有神经炎症和受损的线粒体变化,和褪黑激素/尿石素A(UA)5-氨基咪唑-4-甲酰胺1-β-D-呋喃核糖苷(AICAR)逆转了ApoE4小鼠的这些作用。同时,ApoE4小鼠表现出线粒体自噬缺陷,LPS刺激可能会进一步加剧这种情况,如降低的Atg5,Beclin-1和Parkin水平所示,而PINK1水平升高。然而,褪黑素治疗逆转了这些变化.此外,蛋白质组学分析表明ApoE4小鼠中线粒体相关的信号和网络变化,这可能是对LPS的夸大反应的基础。此外,转染ApoE4的HEK293T细胞显示线粒体相关蛋白和线粒体自噬缺陷,包括PGC-1α,TFAM,p-AMPKα,PINK1和LC3B损伤。此外,它加重线粒体损伤(特别是线粒体自噬),可以通过触发自噬来减弱。总的来说,ApoE4失调增强了LPS刺激后的抑郁行为。
    Apolipoprotein E4 (ApoE4) is involved in the stress-response processes and is hypothesized to be a risk factor for depression by means of mitochondrial dysfunction. However, their exact roles and underlying mechanisms are largely unknown. ApoE4 transgenic mice (B6. Cg-ApoEtm1Unc Cdh18Tg( GFAP-APOE i4)1Hol /J) were subjected to stress (lipopolysaccharides, LPS) to elucidate the aetiology of ApoE4-induced depression. LPS treatment significantly aggravated depression-like behaviours, concurrent with neuroinflammation and impaired mitochondrial changes, and melatonin/Urolithin A (UA) + 5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR) reversed these effects in ApoE4 mice. Concurrently, ApoE4 mice exhibited mitophagy deficits, which could be further exacerbated by LPS stimulation, as demonstrated by reduced Atg5, Beclin-1 and Parkin levels, while PINK1 levels were increased. However, these changes were reversed by melatonin treatment. Additionally, proteomic profiling suggested mitochondria-related signalling and network changes in ApoE4 mice, which may underlie the exaggerated response to LPS. Furthermore, HEK 293T cells transfected with ApoE4 showed mitochondria-associated protein and mitophagy defects, including PGC-1α, TFAM, p-AMPKα, PINK1 and LC3B impairments. Additionally, it aggravates mitochondrial impairment (particularly mitophagy), which can be attenuated by triggering autophagy. Collectively, ApoE4 dysregulation enhanced depressive behaviour upon LPS stimulation.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)的病理生理研究已经深入,载脂蛋白E4(ApoE4)已被证明与AD高度相关,临床和实验数据表明ApoE4可引起血脑屏障(BBB)损伤,而BBB通透性的变更是影响AD发展的重要身分。穿心莲内酯(Andro),作为天然植物穿心莲的活性成分,已被证明具有抗炎和抗氧化作用,具有潜在的神经保护作用。为了验证Andro对血脑屏障的短期保护作用,本课题组采用阿托伐他汀(Atorva)介导的斑马鱼脑损伤模型和ApoE4介导的BBB损伤细胞共培养模型,探讨Andro对BBB损伤的保护作用及机制。研究表明,Andro可以抑制CypA/NF-κB/MMP-9信号通路的激活,并达到了拮抗ApoE4对细胞间紧密连接蛋白(occludin,claudin-5和ZO-1)。同时,Andro能抑制细胞粘附分子(VCAM-1和ICAM-1)的分泌,从而延缓神经炎症的发生和进展,对BBB起到保护作用。总之,Andro是一种有效的天然产品,可以保护血脑屏障。
    The pathological and physiological studies of Alzheimer\'s disease (AD) have been in-depth, and apolipoprotein E4 (ApoE4) has been proven to be highly correlated with AD, and clinical and experimental data show that ApoE4 can cause blood-brain barrier (BBB) injury, and the change of BBB permeability is an important factor affecting the development of AD. Andrographolide (Andro), as the active component of the natural plant Andrographis paniculata, has been proven to have anti-inflammatory and antioxidant effects, which have potential neuroprotective effects. To verify the protective effect of Andro on BBB in a short term, our research group used atorvastatin (Atorva)-mediated zebrafish brain injury model and the ApoE4-mediated cell co-culture model of BBB injury to explore the protective effects and mechanisms of Andro on BBB injury. Studies have shown that Andro can inhibit the activation of CypA/NF-κB/MMP-9 signaling pathway and has achieved the effect of antagonizing the inhibition of ApoE4 on intercellular tight junction proteins (occludin, claudin-5, and ZO-1). At the same time, Andro can inhibit the secretion of cell adhesion molecules (VCAM-1 and ICAM-1) in cells, thereby delaying the occurrence and progression of neuroinflammation and playing a protective role in BBB. In conclusion, Andro is a potent natural product which can protect the blood-brain barrier.
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  • 文章类型: Journal Article
    载脂蛋白E(APOE4)ε4等位基因和衰老是阿尔茨海默病(AD)的主要危险因素。SUMO化与AD的发展和衰老过程密切相关。然而,尚未发现APOE4小鼠的SUMO化状态。在这项研究中,我们研究了老年APOE3和APOE4小鼠大脑中SENP1和SUMOylation的变化,旨在了解它们对APOE4小鼠线粒体代谢的潜在影响及其对细胞衰老的贡献。同时,SUMO1结合蛋白水平下降,而SUMO2/3结合蛋白水平随着APOE4小鼠的衰老而相对增加。这表明SUMO化和去SUMO化过程之间的平衡可能与衰老和寿命有关。我们的发现强调了SENP1和SUMO化变化在APOE4驱动的病理和衰老过程中的重要作用。
    The ε4 allele of apolipoprotein E (APOE4) and aging are the major risk factors for Alzheimer\'s disease (AD). SUMOylation is intimately linked to the development of AD and the aging process. However, the SUMOylation status in APOE4 mice has not been uncovered. In this study, we investigated SENP1 and SUMOylation changes in the brains of aged APOE3 and APOE4 mice, aiming to understand their potential impact on mitochondrial metabolism and their contribution to cellular senescence in APOE4 mice. Concurrently, SUMO1-conjugated protein levels decreased, while SUMO2/3-conjugated protein levels increased relatively with the aging of APOE4 mice. This suggests that the equilibrium between the SUMOylation and deSUMOylation processes may be associated with senescence and longevity. Our findings highlight the significant roles of SENP1 and SUMOylation changes in APOE4-driven pathology and the aging process.
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  • 文章类型: Journal Article
    肝内胆管癌(ICC)是一种预后不良的恶性肿瘤,因此,仍然需要发现有希望的诊断标志物和治疗靶标。在这项研究中,在GSE45001数据集中鉴定了1,852个差异表达基因(DEGs),用于加权基因共表达网络分析(WGCNA),绿松石模块被确认为关键模块。接下来,MCODE分析的绿松石模块中的1,009个基因的子网络,MCC,BottleNeck算法确定了9个重叠基因(CAT,APOA1,APOC2,HSD17B4,EHHADH,APOA2,APOE4,ACOX1,AGXT),与脂质代谢途径显着相关,如过氧化物酶体和胆固醇代谢。其中,在GSE45001和GSE32879数据集中,APOE4在ICC中表现出潜在的肿瘤抑制作用和对ICC的高诊断价值。体外实验证明载脂蛋白E4(APOE4)过表达抑制ICC细胞增殖,迁移,和入侵,击倒是相反的趋势。而在ICC调节脂质代谢中,显著降低TG水平,LDL-C,和HDL-C,同时增加TC的表达式。Further,APOE4也下调脂质代谢相关基因,表明在维持细胞稳态中的关键调节作用,并调节膜蛋白ATP结合盒转运蛋白A1(ABCA1)的表达。这些发现强调了在ICC进展中APOE4和ABCA1对脂质代谢的协调调节。提供对ICC机制和潜在治疗策略的新见解。
    Intrahepatic cholangiocarcinoma (ICC) is a malignancy with a dismal prognosis, thus the discovery of promising diagnostic markers and treatment targets is still required. In this study, 1,852 differentially expressed genes (DEGs) were identified in the GSE45001 dataset for weighted gene co-expression network analysis (WGCNA), and the turquoise module was confirmed as the key module. Next, the subnetworks of the 1,009 genes in the turquoise module analyzed by MCODE, MCC, and BottleNeck algorithms identified nine overlapping genes (CAT, APOA1, APOC2, HSD17B4, EHHADH, APOA2, APOE4, ACOX1, AGXT), significantly associated with lipid metabolism pathways, such as peroxisome and cholesterol metabolism. Among them, APOE4 exhibited a potential tumor-suppressive role in ICC and high diagnostic value for ICC in both GSE45001 and GSE32879 datasets. In vitro experiments demonstrated Apolipoprotein E4 (APOE4) overexpression suppressed ICC cell proliferation, migration, and invasion, knockdown was the opposite trend. And in ICC modulated lipid metabolism, notably decreasing levels of TG, LDL-C, and HDL-C, while concurrently increasing the expressions of TC. Further, APOE4 also downregulated lipid metabolism-related genes, suggesting a key regulatory role in maintaining cellular homeostasis, and regulating the expression of the membrane protein ATP-binding cassette transporter A1 (ABCA1). These findings highlighted the coordinated regulation of lipid metabolism by APOE4 and ABCA1 in ICC progression, providing new insights into ICC mechanisms and potential therapeutic strategies.
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  • 文章类型: Journal Article
    尽管衰老和载脂蛋白E(APOE)ε4等位基因已被证明是迟发性阿尔茨海默病(LOAD)的两个主要危险因素,它们的相互作用和潜在的潜在机制仍未阐明。使用人源化ApoE4-和ApoE3-靶替代小鼠,我们发现老年ApoE4小鼠海马中衰老神经元的积累以及mTOR和内体-溶酶体-自噬(ELA)系统的激活。进一步的分析表明,ApoE4以年龄依赖性方式加重了海马转录和代谢的轮廓变化,伴随着新陈代谢的中断,表现为柠檬酸合成酶的下调活性,ATP水平,最重要的是,乙酰辅酶A(Ac-CoA)的水平;GTA补充剂,Ac-CoA底物,逆转了衰老特征,降低了mTOR和ELA系统的激活,并增强突触结构和增加突触前/后可塑性相关蛋白的水平,导致老年ApoE4小鼠的认知改善。这些数据表明,ApoE4加剧神经元衰老由于缺乏乙酰辅酶A,可以通过补充GTA来改善。这些发现为GTA补充剂对老年APOE4携带者认知改善的潜在治疗价值提供了新的见解。
    Although aging and apolipoprotein E (APOE) ε4 allele have been documented as two major risk factors for late-onset Alzheimer\'s disease (LOAD), their interaction and potential underlying mechanisms remain unelucidated. Using humanized ApoE4- and ApoE3- target replacement mice, we found the accumulation of senescent neurons and the activation of mTOR and endosome-lysosome-autophagy (ELA) system in the hippocampus of aged ApoE4 mice. Further analyses revealed that ApoE4 aggravated the profile change of hippocampal transcription and metabolism in an age-dependent manner, accompanying with an disruption of metabolism, which is presented with the downregulating activity of citrate synthase, the level of ATP and, most importantly, the level of acetyl coenzyme A (Ac-CoA); GTA supplement, an Ac-CoA substrate, reversed the senescent characteristics, decreased the activation of mTOR and ELA system, and enhanced the synaptic structure and increasing level of pre-/post-synaptic plasticity-related protein, leading to cognitive improvement in aged ApoE4 mice. These data suggest that ApoE4 exacerbates neuronal senescence due to a deficiency of acetyl-CoA, which can be ameliorated by GTA supplement. The findings provide novel insights into the potential therapeutic value of GTA supplement for the cognitive improvement in aged APOE4 carriers.
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  • 文章类型: Meta-Analysis
    背景:最近的大量流行病学和临床关联研究报道,ApoE多态性可能与2019年冠状病毒病(COVID-19)的风险和严重程度有关,并产生了不一致的结果。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染依赖于其与宿主细胞膜上表达的血管紧张素转换酶2(ACE2)受体结合的刺突蛋白。
    方法:进行了荟萃分析,以阐明ApoE多态性与COVID-19的风险和严重程度之间的关联。利用多种蛋白质相互作用测定来研究ApoE与SARS-CoV-2主要受体ACE2,ApoE和刺突蛋白之间的潜在分子联系。采用免疫印迹法和免疫荧光染色法研究不同ApoE亚型对ACE2蛋白表达的调控作用。
    结果:ApoE基因多态性(ε4携带者基因型与非ε4携带者基因型)与COVID-19的风险增加(P=0.0003,OR=1.44,95%CI1.18-1.76)和进展(P<0.00001,OR=1.85,95%CI1.50-2.28)相关。ApoE与ACE2和刺突蛋白相互作用,但未显示同种型依赖性结合作用。ApoE4在体外和体内显着下调ACE2蛋白表达,并随后降低AngII向Ang1-7的转化。
    结论:ApoE4以可能不依赖于与刺突蛋白或ACE2的差异相互作用的方式增加SARS-CoV-2的感染性。相反,ApoE4下调ACE2蛋白表达,随后肾素-血管紧张素系统(RAS)的失调可能是ApoE4加剧COVID-19疾病的原因。
    Recent numerous epidemiology and clinical association studies reported that ApoE polymorphism might be associated with the risk and severity of coronavirus disease 2019 (COVID-19), and yielded inconsistent results. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection relies on its spike protein binding to angiotensin-converting enzyme 2 (ACE2) receptor expressed on host cell membranes.
    A meta-analysis was conducted to clarify the association between ApoE polymorphism and the risk and severity of COVID-19. Multiple protein interaction assays were utilized to investigate the potential molecular link between ApoE and the SARS-CoV-2 primary receptor ACE2, ApoE and spike protein. Immunoblotting and immunofluorescence staining methods were used to access the regulatory effect of different ApoE isoform on ACE2 protein expression.
    ApoE gene polymorphism (ε4 carrier genotypes VS non-ε4 carrier genotypes) is associated with the increased risk (P = 0.0003, OR = 1.44, 95% CI 1.18-1.76) and progression (P < 0.00001, OR = 1.85, 95% CI 1.50-2.28) of COVID-19. ApoE interacts with both ACE2 and the spike protein but did not show isoform-dependent binding effects. ApoE4 significantly downregulates ACE2 protein expression in vitro and in vivo and subsequently decreases the conversion of Ang II to Ang 1-7.
    ApoE4 increases SARS-CoV-2 infectivity in a manner that may not depend on differential interactions with the spike protein or ACE2. Instead, ApoE4 downregulates ACE2 protein expression and subsequently the dysregulation of renin-angiotensin system (RAS) may provide explanation by which ApoE4 exacerbates COVID-19 disease.
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  • 文章类型: Journal Article
    APOE基因的APOE4(载脂蛋白Eε4)变体的携带者受到几种与年龄相关的健康风险,包括阿尔茨海默病(AD)。APOE4蛋白的脂质和胆固醇转运能力不足是风险状况改变的一个原因。特别是,APOE4携带者患散发性阿尔茨海默病(AD)的风险升高。虽然错误折叠蛋白质的沉积物存在于AD大脑中,白质(WM)髓鞘也受到干扰。因为髓磷脂是富含脂肪和胆固醇的结构,与APOE的联系具有相当大的生物学意义。要探索APOE-WM连接,我们在体内和体外分析了人APOE4对小鼠少突胶质细胞(OL)的影响。我们发现APOE蛋白在星形胶质细胞中富集,但在OL中稀疏。在人类APOE4(hAPOE4)敲入小鼠中,髓鞘脂质含量增加,但主要髓鞘蛋白的密度(MBP,MAG和PLP)基本不变。我们还发现OL谱系(Olig2)的细胞密度出乎意料但显着降低,并且OL前体(Nkx2.2)的异常积累,表明OL分化的破坏。现有RNA-seq数据集的基因本体论分析证实了对hAPOE4小鼠脑的改变的化学的稳健转录响应。在文化中,洛伐他汀介导的胆固醇合成消耗过程中星形胶质细胞来源的APOE的摄取足以维持OL分化。虽然内源性hAPOE蛋白亚型对OL发育没有影响,外源性hAPOE4消除了极低密度脂蛋白恢复Apoe缺陷的髓鞘形成的能力,胆固醇耗尽的OL。我们的数据表明,APOE4通过中断星形胶质细胞衍生的脂质向少突胶质细胞的递送来损害衰老大脑中的髓鞘形成。我们认为,在APOE4携带者中发现的高髓鞘周转和OL耗竭可能是AD脑APOE依赖性髓鞘表型的解释。
    Carriers of the APOE4 (apolipoprotein E ε4) variant of the APOE gene are subject to several age-related health risks, including Alzheimer\'s disease (AD). The deficient lipid and cholesterol transport capabilities of the APOE4 protein are one reason for the altered risk profile. In particular, APOE4 carriers are at elevated risk for sporadic AD. While deposits o misfolded proteins are present in the AD brain, white matter (WM) myelin is also disturbed. As myelin is a lipid- and cholesterol-rich structure, the connection to APOE makes considerable biological sense. To explore the APOE-WM connection, we have analyzed the impact of human APOE4 on oligodendrocytes (OLs) of the mouse both in vivo and in vitro. We find that APOE proteins is enriched in astrocytes but sparse in OL. In human APOE4 (hAPOE4) knock-in mice, myelin lipid content is increased but the density of major myelin proteins (MBP, MAG, and PLP) is largely unchanged. We also find an unexpected but significant reduction of cell density of the OL lineage (Olig2+ ) and an abnormal accumulation of OL precursors (Nkx 2.2+ ), suggesting a disruption of OL differentiation. Gene ontology analysis of an existing RNA-seq dataset confirms a robust transcriptional response to the altered chemistry of the hAPOE4 mouse brain. In culture, the uptake of astrocyte-derived APOE during Lovastatin-mediated depletion of cholesterol synthesis is sufficient to sustain OL differentiation. While endogenous hAPOE protein isoforms have no effects on OL development, exogenous hAPOE4 abolishes the ability of very low-density lipoprotein to restore myelination in Apoe-deficient, cholesterol-depleted OL. Our data suggest that APOE4 impairs myelination in the aging brain by interrupting the delivery of astrocyte-derived lipids to the oligodendrocytes. We propose that high myelin turnover and OL exhaustion found in APOE4 carriers is a likely explanation for the APOE-dependent myelin phenotypes of the AD brain.
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  • 文章类型: Journal Article
    载脂蛋白E4(APOE4)等位基因与阿尔茨海默病风险增加和青光眼风险降低有关,但潜在的机制仍然知之甚少。这里,我们发现在两种小鼠青光眼模型中,小胶质细胞转变为神经退行性表型,其特征是Apoe和Lgals3(Galectin-3)上调,在人类青光眼视网膜中也被上调。保护小胶质细胞中Apoe靶向缺失或携带人APOE4等位基因的小鼠免受视网膜神经节细胞(RGC)损失,尽管眼内压(IOP)升高。类似于视网膜-/-视网膜小胶质细胞,表达APOE4的小胶质细胞没有上调神经变性相关基因,包括Lgals3,在IOP升高之后。半乳糖凝集素-3改善RGC变性的遗传和药理靶向,人APOE4青光眼样品中半乳糖凝集素-3的表达减弱。这些结果表明,APOE4小胶质细胞的受损活化在青光眼中是保护性的,并且APOE-半乳糖凝集素-3信号传导可以靶向治疗这种致盲疾病。
    The apolipoprotein E4 (APOE4) allele is associated with an increased risk of Alzheimer disease and a decreased risk of glaucoma, but the underlying mechanisms remain poorly understood. Here, we found that in two mouse glaucoma models, microglia transitioned to a neurodegenerative phenotype characterized by upregulation of Apoe and Lgals3 (Galectin-3), which were also upregulated in human glaucomatous retinas. Mice with targeted deletion of Apoe in microglia or carrying the human APOE4 allele were protected from retinal ganglion cell (RGC) loss, despite elevated intraocular pressure (IOP). Similarly to Apoe-/- retinal microglia, APOE4-expressing microglia did not upregulate neurodegeneration-associated genes, including Lgals3, following IOP elevation. Genetic and pharmacologic targeting of Galectin-3 ameliorated RGC degeneration, and Galectin-3 expression was attenuated in human APOE4 glaucoma samples. These results demonstrate that impaired activation of APOE4 microglia is protective in glaucoma and that the APOE-Galectin-3 signaling can be targeted to treat this blinding disease.
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  • 文章类型: Journal Article
    背景:大量研究证实载脂蛋白E4等位基因(APOE4)基因和动脉硬化(AS)对认知功能损害的发生具有共同作用,血脂异常水平与APOE4水平和AS显着相关。很少有研究关注APOE4基因和AS对认知功能的联合作用。因此,本研究旨在探讨APOE4基因和AS通过血脂异常水平共同作用对认知功能的影响,为今后的研究提供一定的科研价值。
    方法:采用多阶段整群抽样的方法对贵州农村地区60岁及以上的老年人进行调查,中国。收集了人口社会学特征,和实验室测试,血脂测量,并进行了体格检查。使用简易精神状态检查(MMSE)来确定认知功能。采用双因素析因设计方差分析分析APOE4基因与AS在认知功能及其结构域上的相互作用。
    结果:共有549名老年受试者符合本研究的条件。析因设计分析结果表明,APOE4基因与AS之间在注意力和算术方面存在显着的相互作用(F=6.878,P=0.009)。
    结论:APOE4基因与AS的结合导致注意力和数字域的水平降低,未来应该关注这些人群。
    BACKGROUND: Numerous studies have confirmed that the apolipoprotein E4 allele (APOE4) gene and arteriosclerosis (AS) have a combined effect on the occurrence of cognitive function impairment, and dyslipidaemia levels are significantly correlated with APOE4 levels and AS. Few studies have focused on the combined effect of the APOE4 gene and AS on cognitive function. Therefore, this study aimed to investigate the effect of APOE4 gene and AS acting together on cognitive function through dyslipidaemia levels, which could provide certain scientific research value for future studies.
    METHODS: A multi-stage cluster sampling method was used to investigate older adults aged 60 years and above in rural areas of Guizhou, China. The demographic sociological characteristics were collected, and laboratory tests, blood lipid measurements, and physical examinations were performed. Mini-Mental State Examination (MMSE) was used to determine cognitive function. Analysis of variance with two-factor factorial design was used to analyse the interaction between the APOE4 gene and AS on cognitive function and its domains.
    RESULTS: A total of 549 elderly subjects were eligible for this study. The result of the factorial design analysis revealed there was a significant interaction between the APOE4 gene and AS in terms of attention and numeracy (F = 6.878, P = 0.009).
    CONCLUSIONS: The combination of the APOE4 gene and AS leads to a decrease in the level of attention and numeracy domains, and certain attention should be focused on such populations in the future.
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