Please wait a minute...
 Home  About the Journal Editorial Board Aims & Scope Peer Review Policy Subscription Contact us
 
Early Edition  //  Current Issue  //  Open Special Issues  //  Archives  //  Most Read  //  Most Downloaded  //  Most Cited
Aging and disease    2018, Vol. 9 Issue (3) : 346-357     DOI: 10.14336/AD.2017.0715
Orginal Article |
Association of ApoE Genetic Polymorphism and Type 2 Diabetes with Cognition in Non-Demented Aging Chinese Adults: A Community Based Cross-Sectional Study
Zhen Jie, Lin Tong, Huang Xiaochen, Zhang Huiqiang, Dong Shengqi, Wu Yifan, Song Linlin, Xiao Rong, Yuan Linhong*
School of Public Health, Capital Medical University, Beijing 100069, China
Download: PDF(649 KB)   HTML
Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks    
Abstract  

Apolipoprotein E (ApoE) gene polymorphism has been implicated in predisposition to diabetes and dementia in old population, but the results from the different studies were inconclusive. A cross-sectional study was carried out to explore the relationship among ApoE gene polymorphism, diabetes and cognition in non-demented aging Chinese adults. A total number of 1000 community dwellers aged 55 years and above were randomly recruited. Demographic information of the participants was collected using well designed self-administered questionnaires. The Montreal Cognitive Assessment (MoCA) test was employed to evaluate the cognitive status of the participants. Semi-quantitative food frequency questionnaire was used to obtain the dietary intake information. Fasting venous blood samples were taken for ApoE genotyping and serum lipid measurements. 238 participants were type 2 diabetes mellitus (T2DM) patients and 145 participants were ApoE4 carriers. ApoE 4-T2DM subjects had higher serum triglyceride (TG) concentration than E2 and E3 carriers (P < 0.05). T2DM subjects carrying ApoE4 had lower cognition than subjects with E2 or E3 carriers (P < 0.05). Comparing to non-type 2 diabetic mild cognitive impaired (nT2DM-MCI) subjects, the type 2 diabetic mild cognitive impaired (T2DM-MCI) subjects have higher serum glucose (Glu) level and lower high-density lipoprotein (HDL-C) level (P < 0.05). The T2DM-MCI subjects carrying ApoE4 have lower cognition than E2 and E3 carriers (P <0.05); and the interaction of ApoE genotype with T2DM was detected (P < 0.05). Our results indicated the association among ApoE gene polymorphism, T2DM and cognitive performance in non-demented aging population. The carrying of ApoE4 predisposed the T2DM subjects and the T2DM-MCI subjects to have poor cognitive performance. Additional experimental studies are required to explore the mechanism that ApoE genotype modifies the risk for cognitive impairment in aging subjects with T2DM.

Keywords apolipoprotein E      polymorphism      type 2 diabetes mellitus      cognitive function      geriatrics     
Corresponding Authors: Yuan Linhong   
About author:

These authors contributed equally to this work.

Issue Date: 05 June 2018
Service
E-mail this article
E-mail Alert
RSS
Articles by authors
Zhen Jie
Lin Tong
Huang Xiaochen
Zhang Huiqiang
Dong Shengqi
Wu Yifan
Song Linlin
Xiao Rong
Yuan Linhong
Cite this article:   
Zhen Jie,Lin Tong,Huang Xiaochen, et al. Association of ApoE Genetic Polymorphism and Type 2 Diabetes with Cognition in Non-Demented Aging Chinese Adults: A Community Based Cross-Sectional Study[J]. Aging and disease, 2018, 9(3): 346-357.
URL:  
http://www.aginganddisease.org/EN/10.14336/AD.2017.0715     OR     http://www.aginganddisease.org/EN/Y2018/V9/I3/346
Demographic characterT2DM
Total (n = 952)P value
No (n = 714)Yes (n = 238)
Age, mean ± SD62.8 ± 5.863.2 ± 5.762.9 ± 5.80.31
Gender, n (%)0.17
male219 (30.7)85 (35.7)304 (31.9)
Female495 (69.3)153 (64.3)648 (68.1)
BMI (kg/m2), mean ± SD25.5 ± 7.625.46 ± 3.425.5 ± 6.80.87
Education, n (%)0.45
Illiterate23 (3.2)12 (5.0)35 (3.7)
Primary school107 (15.0)42 (17.6)149 (15.7)
Junior high school328 (45.9)114 (47.9)442 (46.4)
High school190 (26.6)53 (22.3)243 (25.5)
Junior college42 (5.9)11 (4.6)53 (5.6)
Undergraduate and above24 (3.4)6 (2.5)30 (3.2)
Life style
Living alone, n (%)0.87
Yes44 (6.2)13 (5.5)57 (6.0)
No670 (93.8)225 (94.5)895 (94.0)
Smoking, n (%)0.24
Yes110 (15.4)42 (14.6)152 (16.0)
No604 (84.6)196 (82.4)800 (84.0)
Alcohol drinking, n (%)0.67
Yes199 (27.9)63 (26.5)262 (27.5)
No501 (72.1)175 (73.5)690 (72.5)
Physical activity, n (%)0.14
Never73 (10.2)25 (10.5)98 (10.3)
1-3 times/week98 (13.7)23 (9.7)121 (12.7)
4-5 times/week91 (12.8)22 (9.2)113 (11.9)
everyday451 (63.2)168 (70.6)619 (65.1)
Reading habit, n (%)0.15
Yes342 (47.9)100 (42.0)442 (46.4)
No372 (52.1)138 (58.0)510 (53.6)
Housework doing, n (%)0.15
Yes676 (94.7)220 (92.4)896 (94.3)
No38 (5.3)18 (7.6)56 (5.9)
Table 1  Demographics of the participants.
Parameter, genotype and cognitionT2DM
Total (n = 952)P value
No (n = 714)Yes (n = 238)
Serum parameters (mmol/L), mean (95% CI)
Glu5.4 (5.3, 5.5)7.2 (7.0, 7.4)6.3 (6.2, 6.4)0.00
TC5.1 (5.0, 5.2)5.0 (4.8, 5.1)5.0 (5.0, 5.1)0.12
TG1.8 (1.7, 1.9)2.0 (1.9, 2.2)1.9 (1.8, 2.0)0.00
LDL-C3.2 (3.1, 3.2)3.2 (3.1, 3.3)3.2 (3.1, 3.2)0.67
HDL-C1.4 (1.4, 1.4)1.3 (1.3, 1.3)1.3 (1.3, 1.4)0.00
ApoE genotype, n (%)0.68
E2105 (14.7)29 (12.2)134 (14.1)
E3497 (69.6)176 (74.0)673 (70.7)
E4112 (15.7)33 (13.9)145 (15.2)
Cognition
Visual & executive3.91 (3.8, 4.0)3.8 (3.7, 4.0)3.9 (3.8, 4.0)0.37
Naming2.9 (2.9, 2.9)2.9 (2.9, 3.0)2.9 (2.8, 2.9)0.91
Attention5.3 (5.2, 5.4)5.4 (5.3, 5.6)5.4 (5.3, 5.5)0.09
Language2.2 (2.1, 2.3)2.2 (2.1, 2.4)2.2 (2.2, 2.3)0.58
Abstraction1.6 (1.5, 1.7)1.6 (1.5, 1.7)1.6 (1.6, 1.7)0.69
Memory and delayed recall3.0 (2.9, 3.1)3.1 (2.9, 3.3)3.0 (2.9, 3.1)0.30
Orientation5.8 (5.7, 5.8)5.8 (5.7, 5.9)5.8 (5.7, 5.8)0.63
MoCA score24.9 (24.5, 25.2)25.2 (24.6, 25.8)25.1 (24.7, 25.4)0.29
Table 2  Serum parameter, ApoE genotype and cognition of the participants.
Parameters, genotype and cognitionnT2DM-MCI
(n = 168)
T2DM-MCI
(n = 43)
P value
Serum Parameters (mmol/L)
Glu5.8 (5.5, 6.0)7.5 (7.0, 7.9)0.00
TC5.3 (5.1, 5.5)5.2 (4.8, 5.5)0.61
TG1.8 (1.6, 1.9)2.0 (1.6, 2.3)0.29
LDL-C3.1 (3.0, 3.2)3.2 (2.9, 3.5)0.51
HDL-C1.5 (1.4, 1.5)1.3 (1.2, 1.4)0.00
ApoE genotype, n (%)0.81
E234 (20.2)6 (14.0)
E3111 (66.1)31 (72.1)
E423 (13.7)6 (14.0)
Cognition
Visual & executive3.0 (2.8, 3.2)2.6 (2.2, 3.0)0.09
Naming2.7 (2.6, 2.8)2.6 (2.4, 2.9)0.61
Attention4.3 (4.0, 4.5)4.6 4.1, 5.1)0.27
Language1.3 (1.2, 1.5)1.6 (1.4, 1.9)0.07
Abstraction1.0 (0.8, 1.1)1.0 (0.7, 1.2)0.98
Memory and delayed recall1.5 (1.3, 1.7)1.5 (1.0, 1.9)0.88
Orientation5.3 (5.0, 5.5)5.3 (4.9, 5.8)0.78
MoCA score19.2 (18.3, 20.1)19.4 (17.5, 21.2)0.86
Table 3  Serum parameters, ApoE genotype and cognition in MCI subjects with or without T2DM.
Foods (g/d)nT2DM-MCI
(n = 168)
T2DM-MCI
(n = 43)
P value
Fruit154.5 (139.2, 169.8)121.4 (90.3, 152.6)0.06
Vegetable289.8 (270.1, 309.4)277.2 (237.2, 317.2)0.58
Fruit + Vegetable444.3 (417.7, 470.8)398.6 (344.6, 452.7)0.14
legume29.0 (25.2, 32.8)18.65 (10.9, 26.4)0.02
Cooking oil30.6 (28.0, 33.2)31.18 (25.9, 36.4)0.85
Fish19.4 (17.2, 21.6)17.31 (12.8, 21.8)0.41
Whole grain27.7 (24.9, 30.4)26.1 (20.5, 31.6)0.61
Red meat27.9 (24.0, 31.8)21.5 (13.5, 29.5)0.16
Poultry13.3 (11.2, 15.4)11.5 (7.2, 15.8)0.47
Nut12.7 (10.4, 15.0)10.6 (5.9, 15.3)0.43
Milk191.5 (175.8, 207.3)200.8 (168.6, 232.9)0.62
Egg30.2 (27.7, 32.7)32.1 (27.0, 37.2)0.52
Table 4  Dietary intake of MCI subjects with or without T2DM.
Serum parameters and cognitionApoE E2 (n = 29)ApoE3 (n = 176)ApoE4 (n = 33)P value
Serum Parameters (mmol/L)
Glu7.2 (6.3, 8.1)7.2 (6.8, 7.6)7.3 (6.4, 8.2)0.98
TC5.0 (4.5, 5.4)4.9 (4.7, 5.0)4.9 (4.5, 5.3)0.35
TG2.5 (1.8, 3.1)1.8 (1.6, 2.1)2.6 (2.0, 3.2)0.04
LDL-C2.9 (2.5, 3.3)3.2 (3.0, 3.3)3.1 (2.7, 3.4)0.40
HDL-C1.3 (1.1, 1.4)1.3 (1.3, 1.4)1.2 (1.1, 1.3)0.44
Cognition
Visual & executive3.9 (3.2, 4.5)3.7 (3.2, 4.1)3.3 (2.9, 3.8)0.10
Naming2.9 (2.7, 3.2)2.9 (2.9, 3.0)2.8 (2.6, 2.9)0.14
Attention5.5 (5.1, 5.9)5.4 (5.2, 5.6)5.2 (4.8, 5.6)0.73
Language2.4 (2.1, 2.7)2.2 (2.1, 2.4)1.9 (1.6, 2.2)0.08
Abstraction1.7 (1.5, 2.0)1.6 (1.5, 1.8)1.6 (1.4, 1.9)0.01
Memory and delayed recall2.7 (2.2, 3.3)3.2 (2.9, 3.4)2.9 (2.4, 3.5)0.12
Orientation5.8 (5.6, 6.1)5.8 (5.7, 5.9)5.54 (5.3, 5.8)0.24
MoCA score25.2 (23.6, 26.8)25.5 (24.8, 26.1)23.6 (22.1, 25.0)0.04
Table 5  Serum parameters and cognition according to ApoE genotype in T2DM patients.
Serum parameters and cognitionApoE2 (n=134)ApoE3 (n=673)ApoE4 (n=145)P value

nT2DM (n=105)T2DM
(n=29)
nT2DM (n=497)T2DM
(n=176)
nT2DM (n=112)T2DM
(n=33)
Serum parameter (mmol/L)
Glu5.5 (5.2, 5.9)7.3 (6.7, 7.9)5.4 (5.2, 5.5)7.2 (7.0, 7.5)5.2 (4.9, 5.6)7.3 (6.7, 8.0)0.30
TC5.2 (4.9, 5.4)5.0 (4.6, 5.4)5.0 (4.9, 5.1)4.9 (4.7, 5.1)5.2 (5.0, 5.4)5.0 (4.6, 5.4)0.97
TG2.2 (1.9, 2.5)2.6 (2.0, 3.07)1.7 (1.5, 1.8)1.9 (1.6, 2.1)1.8 (1.5, 2.0)2.6 (2.1, 3.1)0.21
LDL-C2.9 (2.7, 3.1)2.9 (2.6, 3.3)3.2 (3.1, 3.3)3.2 (3.1, 3.3)3.3 (3.1, 3.5)3.1 (2.8, 3.4)0.55
HDL-C1.5 (1.4, 1.6)1.3 (1.1, 1.4)1.4 (1.3, 1.4)1.3 (1.3, 1.4)1.4 (1.4, 1.5)1.2 (1.1, 1.3)0.05
Cognition
Visual & executive3.8 (3.6, 4.1)3.6 (3.2, 4.1)3.9 (3.8, 4.0)4.0 (3.8, 4.1)4.0 (3.7, 4.2)3.4 (3.0, 3.8)0.14
Naming2.9 (2.8, 3.0)2.9 (2.7, 3.0)2.9 (2.9, 3.0)2.9 (2.9, 3.0)2.8 (2.8, 2.9)2.8 (2.6, 2.9)0.63
Attention5.2 (4.9, 5.4)5.5 (5.1, 6.0)5.3 (5.2, 5.4)5.5 (5.3, 5.6)5.4 (5.2, 5.6)5.2 (4.8, 5.6)0.46
Language2.1 (1.9, 2.3)2.4 (2.1, 2.7)2.2 (2.2, 2.3)2.3 (2.1, 2.4)2.2 (2.0, 2.3)2.0 (1.7, 2.3)0.24
Abstraction1.6 (1.4, 1.7)1.8 (1.5, 2.0)1.7 (1.6, 1.7)1.7 (1.5, 1.8)1.6 (1.5, 1.7)1.6 (1.4, 1.8)0.64
Memory and delayed recall3.1 (2.8, 3.4)2.7 (2.2, 3.3)3.1 (2.9, 3.2)3.2 (3.0, 3.4)3.0 (2.7, 3.3)3.0 (2.5, 3.5)0.42
orientation5.8 (5.6, 5.9)5.9 (5.6, 6.18)5.8 (5.7, 5.9)5.9 (5.7, 6.0)5.7 (5.6, 5.9)5.5 (5.2, 5.8)0.48
MoCA score24.5 (23.6, 25.4)25.3 (23.5, 27.0)25.1 (24.7, 25.5)25.7 (25.0, 26.4)24.9 (24.0, 25.8)23.7 (22.1, 25.3)0.38
Table 6  Combine effect of ApoE genotype and T2DM on serum parameters and cognition in aging Chinese subjects.
Serum parameters and cognitionApoE2 (n = 6)ApoE3 (n = 31)ApoE4 (n = 6)P value
Serum Parameters (mmol/L)
Glu6.7 (4.8, 8.6)7.5 (6.7, 8.3)8.9 (6.9, 11.0)0.43
TC4.7 (3.5, 5.9)5.0 (4.5, 5.5)5.5 (4.2, 6.8)0.53
TG1.6 (0.2, 3.0)2.2 (1.6, 2.8)1.9 (0.4, 3.4)0.57
LDL-C2.4 (1.3, 3.5)3.1 (2.7, 3.6)3.2 (2.0, 4.3)0.36
HDL-C1.4 (1.2, 1.7)1.2 (1.1, 1.3)1.1 (0.9, 1.4)0.25
Cognition
Visual & executive2.6 (1.4, 3.8)2.6 (2.1, 3.1)0.6 (-0.6, 1.9)0.01
Naming2.8 (2.1, 3.5)2.8 (2.5, 3.1)1.6 (0.9, 2.4)0.06
Attention4.2 (2.7, 5.8)4.6 (3.9, 5.2)3.2 (1.6, 4.8)0.42
Language2.2 (1.3, 3.1)1.7 (1.3, 2.0)0.5 (-0.5, 1.4)0.09
Abstraction0.8 (0.0, 1.6)1.2 (0.9, 1.5)0.2 (-0.6, 1.1)0.07
Memory and delayed recall0.5 (-0.1, 1.9)1.9 (1.3, 2.4)0.2 (-1.1, 1.6)0.04
Orientation5.3 (4.2, 6.4)5.6 (5.1, 6.0)3.6 (2.4, 4.7)0.02
MoCA score18.1 (13.2, 23.0)20.5 (18.5, 22.5)10.5 (5.3, 15.6)0.01
Table 7  Serum parameters and cognition according to ApoE genotype in T2DM-MCI subjects.
Parameters and cognitionApoE2 (n=40)ApoE3 (n=142)ApoE4 (n=29)P
value

nT2DM-MCI
(n=34)
T2DM-MCI
(n=6)
nT2DM-MCI
(n=111)
T2DM-MCI
(n=31)
nT2DM-MCI
(n=23)
T2DM-MCI
(n=6)
Serum parameters (mmol/L)
Glu5.8 (5.2, 6.4)6.7 (4.8, 8.6)5.6 (5.3, 5.9)7.5 (6.7, 8.3)5.8 (5.1, 6.5)8.9 (6.9, 11.0)0.37
TC5.5 (5.1, 5.9)4.7 (3.5, 5.9)5.1 (4.9, 5.4)5.0 (4.5, 5.5)5.9 (5.3, 6.4)5.5 (4.2, 6.8)0.29
TG2.0 (1.6, 2.5)1.6 (0.2, 3.0)1.6 (1.4, 1.8)2.2 (1.6, 2.8)1.9 (1.4, 2.5)1.9 (0.4, 3.4)0.14
LDL-C2.9 (2.6, 3.3)2.4 (1.3, 3.5)3.1 (2.9, 3.3)3.1 (2.7, 3.6)3.4 (3.0, 3.9)3.2 (2.0, 4.3)0.14
HDL-C1.6 (1.5, 1.7)1.4 (1.2, 1.7)1.6 (1.5, 1.7)1.2 (1.1, 1.3)1.4 (1.4, 1.5)1.1 (0.9, 1.4)0.87
Cognition
Visual & executive3.3 (2.8,3.8)2.6 (1.4, 3.8)3.0 (2.7, 3.3)2.6 (2.1, 3.1)2.7 (2.1, 3.3)0.6 (-0.6, 1.9)0.09
Naming2.8 (2.5, 3.0)2.8 (2.1, 3.5)2.8 (2.6, 2.9)2.8 (2.5, 3.1)2.3 (1.9, 2.6)1.6 (0.9, 2.4)0.18
Attention4.4 (3.8, 5.0)4.3 (2.7, 5.8)4.2 (3.8, 4.5)4.6 (3.9, 5.2)3.9 (3.2, 4.6)3.2 (1.6, 4.8)0.39
Language1.3 (1.1, 1.7)2.2 (1.3, 3.1)1.3 (1.1, 1.5)1.7 (1.3, 2.0)1.1 (0.8, 1.5)0.5 (-0.5, 1.4)0.06
Abstraction0.8 (0.5, 1.1)0.8 (0.0, 1.6)1.1 (0.9, 1.3)1.2 (0.9, 1.5)0.9 (0.5, 1.2)0.2 (-0.6, 1.1)0.32
Memory and delayed recall1.6 (1.2, 2.1)0.5 (-1.0, 1.9)1.6 (1.3, 1.8)1.7 (1.3, 2.4)1.6 (1.0, 2.2)0.2 (-1.1, 1.6)0.20
orientation5.2 (4.7, 5.8)5.3 (4.2, 6.4)5.2 (4.9, 5.5)5.6 (5.1, 6.0)5.0 (4.4, 5.6)3.6 (2.4, 4.7)*0.01
MoCA score19.6 (17.5, 21.7)18.1 (13.2, 23.0)19.3 (18.1, 20.5)20.5 (18.5, 22.5)17.6 (15.0, 20.1)10.5 (5.3, 15.1)*0.03
Table 8  Combine effect of ApoE genotype and T2DM on serum parameters and cognition in MCI subjects,
[1] Rivillas-Acevedo L, Sanchez-Lopez C, Amero C, Quintanar L (2015). Structural basis for the inhibition of truncated islet amyloid polypeptide aggregation by cu (ii): Insights into the bioinorganic chemistry of type ii diabetes. Inorg Chem, 54:3788-96.
[2] Xu Y, Wang L, He J, Bi Y, Li M, Wang T, Wang L, Jiang Y, Dai M, Lu J, Xu M, Li Y, Hu N, Li J, Mi S, Chen CS, Li G, Mu Y, Zhao J, Kong L, Chen J, Lai S, Wang W, Zhao W, Ning G (2013). Prevalence and control of diabetes in Chinese adults. JAMA, 310: 948-59.
[3] Leibson CL, Rocca WA, Hanson VA, Cha R, Kokmen E, O’Brien PC, Palumbo PJ (1997). The risk of dementia among persons with diabetes mellitus: A population-based cohort study. Ann N Y Acad Sci, 826: 422-7.
[4] Brayne C, Gill C, Huppert FA, Barkley C, Gehlhaar E, Girling DM, O’Connor DW, Paykel ES (1998). Vascular risks and incident dementia: Results from a cohort study of the very old. Dement Geriatr Cogn Disord, 9:175-80.
[5] Irie F, Fitzpatrick AL, Lopez OL, Kuller LH, Peila R, Newman AB, Launer LJ (2008). Enhanced risk for Alzheimer disease in persons with type 2 diabetes and apoe epsilon4: The cardiovascular health study cognition study. Arch Neurol, 65:89-93.
[6] Cheng PY, Sy HN, Wu SL, Wang WF, Chen YY (2012). Newly diagnosed type 2 diabetes and risk of dementia: A population-based 7-year follow-up study in Taiwan. J Diabetes Complications, 26:382-7.
[7] Strachan MW, Reynolds RM, Marioni RE, Price JF (2011). Cognitive function, dementia and type 2 diabetes mellitus in the elderly. Nat Rev Endocrinol, 7:108-14.
[8] Zhao WQ, Townsend M (2009). Insulin resistance and amyloidogenesis as common molecular foundation for type 2 diabetes and Alzheimer’s disease. Biochim Biophys Acta, 1792:482-96.
[9] Lin CH, Sheu WH (2013). Hypoglycaemic episodes and risk of dementia in diabetes mellitus: 7-year follow-up study. J Intern Med, 273:102-10.
[10] West RK, Ravona-Springer R, Heymann A, Schmeidler J, Leroith D, Koifman K, Guerrero-Berroa E, Preiss R, Hoffman H, Silverman JM, Beeri MS (2015). Shorter adult height is associated with poorer cognitive performance in elderly men with type ii diabetes. J Alzheimers Dis, 44:927-35.
[11] Mayeda ER, Haan MN, Neuhaus J, Yaffe K, Knopman DS, Sharrett AR, Griswold ME, Mosley TH (2014). Type 2 diabetes and cognitive decline over 14 years in middle-aged african americans and whites: The aric brain mri study. Neuroepidemiology, 43:220-7.
[12] Sijbrands EJ, Westendorp RG, Hoffer MJ, Havekes LM, Frants RR, Meinders AE, Frolich M, Smelt AH (1994). Effect of insulin resistance, apoe2 allele, and smoking on combined hyperlipidemia. Arterioscler Thromb, 14:1576-80.
[13] Anthopoulos PG, Hamodrakas SJ, Bagos PG (2010). Apolipoprotein e polymorphisms and type 2 diabetes: A meta-analysis of 30 studies including 5423 cases and 8197 controls. Mol Genet Metab, 100: 283-91.
[14] Messier C (2003). Diabetes, Alzheimer’s disease and apolipoprotein genotype. Exp Gerontol, 38: 941-6.
[15] Schipper HM (2011). Apolipoprotein e: Implications for ad neurobiology, epidemiology and risk assessment. Neurobiol Aging, 32:778-90.
[16] Farrer LA, Cupples LA, Haines JL, Hyman B, Kukull WA, Mayeux R, Myers RH, Pericak-Vance MA, Risch N, van Duijn CM (1997). Effects of age, sex, and ethnicity on the association between apolipoprotein e genotype and alzheimer disease. A meta-analysis. Apoe and Alzheimer disease Meta analysis consortium. JAMA, 278:1349-56.
[17] Corder EH, Saunders AM, Strittmatter WJ, Schmechel DE, Gaskell PC, Small GW, Roses AD, Haines JL, Pericak-Vance MA (1993). Gene dose of apolipoprotein e type 4 allele and the risk of Alzheimer’s disease in late onset families. Science, 261: 921-3.
[18] Nagy Z, Esiri MM, Jobst KA, Johnston C, Litchfield S, Sim E, Smith AD (1995). Influence of the apolipoprotein e genotype on amyloid deposition and neurofibrillary tangle formation in Alzheimer’s disease. Neuroscience, 69: 757-61.
[19] Perl DP (2010). Neuropathology of Alzheimer’s disease. Mt Sinai J Med, New York, 77:32-42.
[20] Vagelatos NT, Eslick GD (2013). Type 2 diabetes as a risk factor for Alzheimer’s disease: The confounders, interactions, and neuropathology associated with this relationship. Epidemiol Rev, 35:152-60.
[21] Umegaki H (2014). Type 2 diabetes as a risk factor for cognitive impairment: Current insights. Clin Interv Aging, 9:1011-9.
[22] Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H (2005). The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 53: 695-9.
[23] Luis CA, Keegan AP, Mullan M (2009). Cross validation of the montreal cognitive assessment in community dwelling older adults residing in the southeastern US. Int J Geriatr Psychiatry, 24:197-201.
[24] Lu J, Li D, Li F, Zhou A, Wang F, Zuo X, Jia XF, Song H, Jia J (2011). Montreal cognitive assessment in detecting cognitive impairment in Chinese elderly individuals: A population-based study. J Geriatr Psychiatry Neurol, 24:184-90.
[25] Zhang W, Li Q, Shi L, Lu K, Shang Q, Yao L, Ye G (2009). Investigation of dietary intake of cadmium in certain polluted area of south in china. Wei Sheng Yan Jiu (Chinese), 38:552-4.
[26] Hixson JE, Vernier DT (1990). Restriction isotyping of human apolipoprotein e by gene amplification and cleavage with Hhal. J Lipid Res, 31:545-8.
[27] Friedewald WT, Levy RI, Fredrickson DS (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem, 18:499-502.
[28] Sheen YJ, Sheu WH (2016). Association between hypoglycemia and dementia in patients with type 2 diabetes. Diabetes Res Clin Pract, 116:279-87.
[29] Umegaki H, Hayashi T, Nomura H, Yanagawa M, Nonogaki Z, Nakshima H, Kuzuya M (2013). Cognitive dysfunction: An emerging concept of a new diabetic complication in the elderly. Geriatr Gerontol Int, 13:28-34.
[30] Kouta Y, Sakurai T, Yokono K (2006). Cognitive dysfunction and dementia associated with elderly diabetes. Nihon Rinsho, 64:119-23.
[31] Lee JH, Choi Y, Jun C, Hong YS, Cho HB, Kim JE, Lyoo IK (2014). Neurocognitive changes and their neural correlates in patients with type 2 diabetes mellitus. Endocrinol Metab, 29:112-21.
[32] Wong RH, Scholey A, Howe PR (2014). Assessing premorbid cognitive ability in adults with type 2 diabetes mellitus-a review with implications for future intervention studies. Curr Diab Rep, 14:547.
[33] Ghasemi R, Haeri A, Dargahi L, Mohamed Z, Ahmadiani A (2013). Insulin in the brain: Sources, localization and functions. Mol Neurobiol, 47:145-71.
[34] Wang Y, Xu XY, Feng CH, Li YL, Ge X, Zong GL, Wang YB, Feng B, Zhang P (2015). Patients with type 2 diabetes exhibit cognitive impairment with changes of metabolite concentration in the left hippocampus. Metab Brain Dis, 30:1027-34.
[35] El-Lebedy D, Raslan HM, Mohammed AM (2016). Apolipoprotein e gene polymorphism and risk of type 2 diabetes and cardiovascular disease. Cardiovasc Diabetol, 15:12.
[36] Windler E (2005). What is the consequence of an abnormal lipid profile in patients with type 2 diabetes or the metabolic syndrome? Atheroscler Suppl, 6:11-4.
[37] Taskinen MR (2002). Diabetic dyslipidemia. Atheroscler Suppl, 3: 47-51.
[38] Janson J, Laedtke T, Parisi JE, O’Brien P, Petersen RC, Butler PC (2004). Increased risk of type 2 diabetes in alzheimer disease. Diabetes, 53:474-81.
[39] To AW, Ribe EM, Chuang TT, Schroeder JE, Lovestone S (2011). The epsilon3 and epsilon4 alleles of human apoe differentially affect tau phosphorylation in hyperinsulinemic and pioglitazone treated mice. PloS One, 6:e16991.
[40] Chaudhary R, Likidlilid A, Peerapatdit T, Tresukosol D, Srisuma S, Ratanamaneechat S, Sriratanasathavorn C (2012). Apolipoprotein e gene polymorphism: Effects on plasma lipids and risk of type 2 diabetes and coronary artery disease. Cardiovasc Diabetol, 11:36.
[41] Gomez-Coronado D, Alvarez JJ, Entrala A, Olmos JM, Herrera E, Lasuncion MA (1999). Apolipoprotein e polymorphism in men and women from a spanish population: Allele frequencies and influence on plasma lipids and apolipoproteins. Atherosclerosis, 147:167-76.
[42] Palta P, Schneider AL, Biessels GJ, Touradji P, Hill-Briggs F (2014). Magnitude of cognitive dysfunction in adults with type 2 diabetes: A meta-analysis of six cognitive domains and the most frequently reported neuropsychological tests within domains. J Int Neuropsychol Soc, 20: 278-91.
[43] Reijmer YD, Brundel M, de Bresser J, Kappelle LJ, Leemans A, Biessels GJ (2013). Microstructural white matter abnormalities and cognitive functioning in type 2 diabetes: A diffusion tensor imaging study. Diabetes care, 36:137-44.
[44] Yeung SE, Fischer AL, Dixon RA (2009). Exploring effects of type 2 diabetes on cognitive functioning in older adults. Neuropsychology, 23:1-9.
[45] Biessels GJ, Strachan MW, Visseren FL, Kappelle LJ, Whitmer RA (2014). Dementia and cognitive decline in type 2 diabetes and prediabetic stages: Towards targeted interventions. Lancet Diabetes Endocrinol, 2:246-55.
[46] Peila R, Rodriguez BL, Launer LJ (2002). Type 2 diabetes, apoe gene, and the risk for dementia and related pathologies: The honolulu-asia aging study. Diabetes, 51:1256-62.
[1] Manuel Scimeca, Federica Centofanti, Monica Celi, Elena Gasbarra, Giuseppe Novelli, Annalisa Botta, Umberto Tarantino. Vitamin D Receptor in Muscle Atrophy of Elderly Patients: A Key Element of Osteoporosis-Sarcopenia Connection[J]. Aging and disease, 2018, 9(6): 952-964.
[2] Faheemuddin Azher Ahmed. Kidney Disease in Elderly: Importance of Collaboration between Geriatrics and Nephrology[J]. A&D, 2018, 9(4): 745-747.
[3] Ting Shen,Yuyi You,Chitra Joseph,Mehdi Mirzaei,Alexander Klistorner,Stuart L. Graham,Vivek Gupta. BDNF Polymorphism: A Review of Its Diagnostic and Clinical Relevance in Neurodegenerative Disorders[J]. A&D, 2018, 9(3): 523-536.
[4] Lourenco Joana, Serrano Antonio, Santos-Silva Alice, Gomes Marcos, Afonso Claudia, Freitas Paula, Paul Constanca, Costa Elisio. Cardiovascular Risk Factors Are Correlated with Low Cognitive Function among Older Adults Across Europe Based on The SHARE Database[J]. Aging and disease, 2018, 9(1): 90-101.
[5] Simone Garcovich,Giuseppe Colloca,Pietro Sollena,Bellieni Andrea,Lodovico Balducci,William C. Cho,Roberto Bernabei,Ketty Peris. Skin Cancer Epidemics in the Elderly as An Emerging Issue in Geriatric Oncology[J]. A&D, 2017, 8(5): 643-661.
[6] Giuseppe Pasqualetti,Marta Seghieri,Eleonora Santini,Chiara Rossi,Edoardo Vitolo,Livia Giannini,Maria Giovanna Malatesta,Valeria Calsolaro,Fabio Monzani,Anna Solini. P2X7 Receptor and APOE Polymorphisms and Survival from Heart Failure: A Prospective Study in Frail Patients in a Geriatric Unit[J]. A&D, 2017, 8(4): 434-441.
[7] Massimo De Martinis,Maria Maddalena Sirufo,Lia Ginaldi. Allergy and Aging: An Old/New Emerging Health Issue[J]. A&D, 2017, 8(2): 162-175.
[8] Jue Wang,Bin Cao,Dong Han,Miao Sun,Juan Feng. Long Non-coding RNA H19 Induces Cerebral Ischemia Reperfusion Injury via Activation of Autophagy[J]. A&D, 2017, 8(1): 71-84.
[9] Johanna Baumgaertel,Robert Haussmann,Antonia Gruschwitz,Annett Werner,Antje Osterrath,Jan Lange,Katharina L. Donix,Jennifer Linn,Markus Donix. Education and Genetic Risk Modulate Hippocampal Structure in Alzheimer’s Disease[J]. A&D, 2016, 7(5): 553-560.
[10] Jing-Zhan Zhang,Xiang Xie,Yi-Tong Ma,Ying-Ying Zheng,Yi-Ning Yang,Xiao-Mei Li,Zhen-Yan Fu,Chuan-Fang Dai,Ming-Ming Zhang,Guo-Ting Yin,Fen Liu,Bang-Dang Chen,Min-Tao Gai. Association between Apolipoprotein C-III Gene Polymorphisms and Coronary Heart Disease: A Meta-analysis[J]. A&D, 2016, 7(1): 36-44.
[11] Chuan-Fang Dai, Xiang Xie, Yi-Tong Ma, Yi-Ning Yang, Xiao-Mei Li, Zhen-Yan Fu, Fen Liu, Bang-Dang Chen, Min-Tao Gai. Relationship between CYP17A1 Genetic Polymorphism and Essential Hypertension in a Chinese Population[J]. A&D, 2015, 6(6): 486-498.
[12] Nora S. Vyas,Yohan Lee,Kwangmi Ahn,Andrew Ternouth,Daniel R. Stahl,Ammar Al-Chalabi,John F. Powell,Basant K. Puri. Association of a Serotonin Receptor 2A Gene Polymorphism with Visual Sustained Attention in Early-Onset Schizophrenia Patients and their Non-Psychotic Siblings[J]. Aging and Disease, 2012, 3(4): 291-300.
Viewed
Full text


Abstract

Cited

  Shared   
Copyright © 2014 Aging and Disease, All Rights Reserved.
Address: Aging and Disease Editorial Office 3400 Camp Bowie Boulevard Fort Worth, TX76106 USA
Fax: (817) 735-0408 E-mail: editorial@aginganddisease.org
Powered by Beijing Magtech Co. Ltd