Relationship Between Apolipoprotein E Polymorphism And Fasting Insulin, Postprandial Insulin And Cognitive Function In Primary Hypertension Patients

[Objective]: To study the relationship between apolipoprotein E polymorphism and cognitive function in primary hypertension patients, to analyze the risk factors of hypertensive-cognitive impairment, and to study the joint effect of the ApoE polymorphism and insulin levels on hypertensive- cognitive impairment. The purpose is providding beneficial evidence for clinical early diagnosis and prevention of hypertensive cognitve impairment.[Methods]: 200 hypertensive patients were included. We collected the general data and applied the Mini Mental State Examination(MMSE) to test the cognitive function and computed score. Full-automatic bio-chemistry analyzer was used to determine total cholesterol (TC) and triglyeride (TG). A Glucose assay kit by GOD-PAP method for the determination of fasting plasma glucose(FPG) and postprandial blood sugar(PPBS). A highly sensitive ria for the determination of fasting inslin (FINS) and postprandial plasma insulin(PINS). And used the polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) for the analysis of the apolipoprotein E polymorphism. [Results]: 1. In primary hypertension patients, the genotype frequency ofε3/4(37%) andε4/4(17%) are significantly higher in the cognitive impairment group than in the cognitive normal group, The differences is obvious (P=0.00). The allele frequency ofε4(40%) is obviously higher in the cognitive impairment group than in the cognitive normal group(15%), and the difference is statistically significant (P= 0.00). 2. Age, cultural level, postprandial plasma insulin andε4/4 genetype all are the important influential factors of hypertensive- cognitive impairment. The cultural levels (middle school and above) are the protective factors for hypertensive-cognitive impairmen(OR=0.037, 0.004, P＜0.05). The age, postprandial plasma insulin(PINS) andε4/4 genetype are the risk factors(OR=1. 111, 1.021, 22.476, P＜0.05), and the differences are obvious. The cognitve score is obviously lower in the high PINS/ε4 (24.95±3.67) than in the normal PINS/ε4 (28.54±2.30) and the high PINS/no 84(27.22+4.32).The difference was statistically significant (P<0.05) .[Conelusions]: 1. In primary hypertension patients, ApoE polymophysims is associated with cognitive impairment, and ApoEε4 allele is a risk factor for the cognitive impairment. 2. In primary hypertension patients, the cognitive impairment is associated with multiple factor too. Age, PINS& ApoE genetype are risk factors for the hypertensive-cognitive impairment. The cultural levels (middle school and above) are the protective factors. 3. There is joint effect of theε4 allele and PINS on the hypertensive-cognitive impairment.