Effect Of Hypertension And Apolipoprotein E Gene Polymorphism On The Age At Onset Of Alzheimer's Disease

Background and Purpose Large-scale epidemiological statistics show that the incidence of China's Alzheimer's disease(Alzheimer's disease, AD) increased year by year, now it has been gradually approaching Western Europe and other developed countries, AD has become the fourth fatal disease only after cardiovascular disease, cancer and cerebrovascular disease. New research suggests that Alzheimer's disease(AD) which associated with aging has the same risk factors with cerebrovascular disease [1].Apolipoprotein E(apolipoprotein E, Apo E) ?4 allele is the only confirmed risk factor for sporadic and late-onset AD, cerebrovascular disease risk factors such as hypertension has been gradually recognized by scholars as risk factors of AD. The main purpose of this study is to explore the impact of hypertension and Apo E gene at the age at onset(age at onset, AAO) of patients in Henan Alzheimer population, provide the basis for clinical prevention of AD occur.Materials and Methods Selected 182 cases of AD patients diagnosised in outpatient ward and clinical by the First Affiliated Hospital of Zhengzhou University and the Second Affiliated Hospital of Zhengzhou University in Henan Province from June 2010 to June 2015.First, all AD patients must entry their information in outpatient and then complete the detailed clinical assessment and evaluation cognitive scales, and finally to improve the head CT or MR of hippocampus. Exsanguinate drawn blood, extracted DNA from human whole blood by DNA extraction kits, using the polymerase chain reactionligase detection reaction(PCR-LDR) technology for genotyping. Enter the data obtained by the study into the database, applicate SPSS17.0 software for statistical analysis. Compare the relationship between different Apo E genotypes and hypertension with the AAO of AD patients by ANOVA(analysis of variance, ANOVA). At the same time according to weather a hypertension history consisted, compare the difference between the AAO of different Apo E allele of AD patients with or without hypertension diseases.Result After finishing the data, a total of 182 cases of AD patients has enrolled. 182 cases of AD onset age was(68.6±9.5) years, of which 63 cases of early-onset Alzheimer's disease(early onset Alzheimer's disease, EOAD) average age was(53.8 ±5.8) years, 119 cases of late-onset Alzheimer(late onset Alzheimer's disease, LOAD) average age was(74.0±5.8) years. Only in LOAD patients, there was a significant difference with the AAO between five genotypes(F= 5.56, P=0.0003), age of onset is descending order ?2/3> ?2/4> ?3/3> ?3/4> ?4/4. There was no significant difference between EOAD and AD patients(respectively: F=0.49, P=0.7411; F=0.79, P=0.5270). There was no statistically difference between the AAO of AD, EOAD and LOAD patients with ?2(+) and ?2(-). Between three ?4 gene types, the difference of AAO of LOAD patients was statistically different(F=6.52, P=0.0021), The AAO of who carry the ?4 gene was significantly lower than non-?4 carriers, and the reduce of the AAO was in a dose dependent manner with the ?4 gene carriers; but there was no significantly difference between all AD and EOAD patients from the three genotypes(respectively: F=0.69, P=0.4648; F=0.96, P=0.3746). The average age at onset of 92 cases of hypertension AD patients was(66.1± 9.8) years, and that of 90 cases without hypertension AD group was(71.0±8.5) years, there was no significantly difference between the AAO of the two groups(t=0.40, P= 0.589). After stratification according to a history of hypertension, there was no significantly difference between the AAO of ?4-/-, ?4+/- and ?4+/+ genotypes in LOAD patients who had a history of hypertension(F = 2.18, P = 0.1453). Differ from LOAD crowd, Whether with a history of hypertension, there was no significantly difference between AAO of three genotypes of EOAD patients(F=0.54, P=0.5826; F=0.89, P=0.4251).Conclusion1.LOAD patients containing Apo E ?4 allele and genotype can reduce its age at onset, the effect has a dose-dependent of ?4 gene. 2.Apo E allele and genotype has no relationship with the age at onset of EOAD patients. 3.Hypertension has no significantly effect on the age at onset of AD patients. 4.Hypertension may weaken or eliminate the effect of Apo E ?4 allele of the age at onset of LOAD.