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Potential Sex-Specific Effects of Apolipoprotein E ɛ4 on Cognitive Decline in Early Parkinson’s Disease
Journal of Parkinson’s Disease ( IF 4.0 ) Pub Date : 2020-12-03 , DOI: 10.3233/jpd-202288
Ryul Kim 1 , Sangmin Park 2 , Dallah Yoo 3 , Young Ju Suh 4 , Jin-Sun Jun 5 , Beomseok Jeon 6
Affiliation  

Background/Objective: To compare the longitudinal trajectories of cognition according to the presence of the apolipoprotein E (APOE) ɛ4 allele in male and female Parkinson’s disease (PD) patients. Methods:This study included a total of 361 patients with recently diagnosed de novo PD (mean age [standard deviation], 61.4 [9.8] years). The patients were classified into the following groups: APOE ɛ4 + /M (n = 65), APOE ɛ4-/M (n = 173), APOE ɛ4 + /F (n = 25), and APOE ɛ4-/F (n = 98). Cognitive decline was assessed annually over 5 years of follow-up using the Montreal Cognitive Assessment (MoCA). To assess the sex-specific impacts of the APOE ɛ4 status on cognitive decline, we used generalized linear mixed effects (GLME) models separately for men, women, and the two sexes combined. Results: In the sex-stratified GLME models adjusted for covariates, the interaction results showed that the males with APOE ɛ4 had a steeper rate of cognitive decline than those without APOE ɛ4. In contrast, there was no significant interaction between APOE ɛ4 and time on longitudinal MoCA performance in the females. The main effect of APOE ɛ4 on the change in the MoCA score was not significant for either men or women. When the data from both men and women were used, the APOE ɛ4 + /M group exhibited a steeper rate of cognitive decline than did the APOE ɛ4 + /F and APOE ɛ4-/F groups. These results were consistent with those of sensitivity analyses. Conclusion: Sex may be considered when APOE ɛ4-related vulnerability to early cognitive decline is evaluated in PD patients.

中文翻译:

载脂蛋白 E ɛ4 对早期帕金森病认知衰退的潜在性别特异性影响

背景/目的:根据载脂蛋白 E (APOE) ɛ4 等位基因在男性和女性帕金森病 (PD) 患者中的存在,比较认知的纵向轨迹。方法:本研究共纳入 361 名最近诊断为新发 PD 的患者(平均年龄 [标准差],61.4 [9.8] 岁)。将患者分为以下几组:APOE ɛ4 + /M (n = 65)、APOE ɛ4-/M (n = 173)、APOE ɛ4 + /F (n = 25)和APOE ɛ4-/F (n = 173) = 98)。使用蒙特利尔认知评估 (MoCA) 在 5 年的随访期间每年评估认知衰退。为了评估 APOE ɛ4 状态对认知能力下降的性别特异性影响,我们分别对男性、女性和两种性别组合使用了广义线性混合效应 (GLME) 模型。结果:在针对协变量调整的性别分层 GLME 模型中,交互作用结果表明,与没有 APOE ɛ4 的男性相比,具有 APOE ɛ4 的男性认知能力下降的速度更快。相比之下,APOE ɛ4 与女性纵向 MoCA 表现的时间之间没有显着的相互作用。APOE ɛ4 对 MoCA 评分变化的主要影响对男性或女性均不显着。当使用男性和女性的数据时,APOE ɛ4 + /M 组表现出比 APOE ɛ4 + /F 和 APOE ɛ4-/F 组更陡峭的认知下降速度。这些结果与敏感性分析的结果一致。结论:当在 PD 患者中评估 APOE ɛ4 相关的早期认知衰退易感性时,可以考虑性别。APOE ɛ4 和时间对雌性纵向 MoCA 表现没有显着的相互作用。APOE ɛ4 对 MoCA 评分变化的主要影响对男性或女性均不显着。当使用男性和女性的数据时,APOE ɛ4 + /M 组表现出比 APOE ɛ4 + /F 和 APOE ɛ4-/F 组更陡峭的认知下降速度。这些结果与敏感性分析的结果一致。结论:当在 PD 患者中评估 APOE ɛ4 相关的早期认知衰退易感性时,可以考虑性别。APOE ɛ4 和时间对雌性纵向 MoCA 表现没有显着的相互作用。APOE ɛ4 对 MoCA 评分变化的主要影响对男性或女性均不显着。当使用男性和女性的数据时,APOE ɛ4 + /M 组表现出比 APOE ɛ4 + /F 和 APOE ɛ4-/F 组更陡峭的认知下降速度。这些结果与敏感性分析的结果一致。结论:当在 PD 患者中评估 APOE ɛ4 相关的早期认知衰退易感性时,可以考虑性别。APOE ɛ4 + /M 组表现出比 APOE ɛ4 + /F 和 APOE ɛ4-/F 组更陡峭的认知下降速度。这些结果与敏感性分析的结果一致。结论:当在 PD 患者中评估 APOE ɛ4 相关的早期认知衰退易感性时,可以考虑性别。APOE ɛ4 + /M 组表现出比 APOE ɛ4 + /F 和 APOE ɛ4-/F 组更陡峭的认知下降速度。这些结果与敏感性分析的结果一致。结论:当在 PD 患者中评估 APOE ɛ4 相关的早期认知衰退易感性时,可以考虑性别。
更新日期:2020-12-08
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