Apolipoprotein E Genotype and Sex Risk Factors for Alzheimer Disease

作者：Scott Neu, Judy Pa, Walter A. Kukull, Duane L. Beekly, Amanda B. Kuzma, Prabhakaran Gangadharan, Li-San Wang, Klaus Romero, Stephen P. Arnerić, Alberto Redolfi, Daniele Orlandi, Giovanni Battista Frisoni, Rhoda Au, Sherral Devine, Sanford H. Auerbach, Ana Espinosa, Merçé Boada, Agustı́n Ruiz, Sterling C. Johnson, Rebecca L. Koscik, Jiun‐Jie Wang, Wen‐Chuin Hsu, Yao-Liang Chen, Arthur W. Toga · 发表于：JAMA Neurology · 年份：2017 · DOI：10.1001/jamaneurol.2017.2188 · 被引用次数：690 · 研究领域：Dementia and Cognitive Impairment Research、Alzheimer's disease research and treatments、Schizophrenia research and treatment

Importance: It is unclear whether female carriers of the apolipoprotein E (APOE) ε4 allele are at greater risk of developing Alzheimer disease (AD) than men, and the sex-dependent association of mild cognitive impairment (MCI) and APOE has not been established. Objective: To determine how sex and APOE genotype affect the risks for developing MCI and AD. Data Sources: Twenty-seven independent research studies in the Global Alzheimer's Association Interactive Network with data on nearly 58 000 participants. Study Selection: Non-Hispanic white individuals with clinical diagnostic and APOE genotype data. Data Extraction and Synthesis: Homogeneous data sets were pooled in case-control analyses, and logistic regression models were used to compute risks. Main Outcomes and Measures: Age-adjusted odds ratios (ORs) and 95% confidence intervals for developing MCI and AD were calculated for men and women across APOE genotypes. Results: Participants were men and women between ages 55 and 85 years. Across data sets most participants were white, and for many participants, racial/ethnic information was either not collected or not known. Men (OR, 3.09; 95% CI, 2.79-3.42) and women (OR, 3.31; CI, 3.03-3.61) with the APOE ε3/ε4 genotype from ages 55 to 85 years did not show a difference in AD risk; however, women had an increased risk compared with men between the ages of 65 and 75 years (women, OR, 4.37; 95% CI, 3.82-5.00; men, OR, 3.14; 95% CI, 2.68-3.67; P = .002). Men with APOE ε3/ε4 had an...