载脂蛋白E4基因与阿尔茨海默病伴睡眠障碍患者血脂、炎症因子及抑郁相关因子的关系

Relationship among the presence of ApoE4 allele and blood lipids, inflammatory factors and molecules associated with depression in AD patients with sleep disorder

摘要:

目的 探究载脂蛋白E4（ApoE4）基因与阿尔茨海默病（AD）伴睡眠障碍患者炎症因子、脑源性神经营养因子（BNDF）、5-羟色胺（5-HT）的关系。方法 选取2018年6月—2020年7月在海南医学院第二附属医院就诊的78例AD患者，根据匹兹堡睡眠质量指数（PSQI）量表将患者分为伴有睡眠障碍组（42例）及未伴有睡眠障碍组（36例），另取同期该院50例健康体检者作为健康组。分析所有受试者ApoE等位基因分布情况，比较AD伴睡眠障碍ApoE4携带组与未携带组患者血脂、炎症因子及抑郁相关因子水平。结果 健康组、伴有睡眠障碍组、未伴有睡眠障碍组ApoE2、ApoE3携带者占比比较，差异无统计学意义（P >0.05）。伴有睡眠障碍组ApoE4携带者占比高于健康组和未伴有睡眠障碍组（P <0.05），而健康组与未伴有睡眠障碍组ApoE4携带者占比比较，差异无统计学意义（P >0.05）。AD伴睡眠障碍ApoE4携带组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、肿瘤坏死因子（TNF-α）、白细胞介素-6（IL-6）及白细胞介素-1β（IL-1β）水平高于未携带组（P <0.05），ApoE4携带组BNDF、5-HT水平低于未携带组（P <0.05）。结论 AD患者伴睡眠障碍与ApoE4基因多态性有关，其中ApoE4对该类患者影响最显著，其原因可能与ApoE4对患者血脂、炎症因子及抑郁相关因子水平的调控有关。

Abstract:

Objective To explore the relationship among the presence of ApoE4 allele and inflammatory factors, brain-derived neurotrophic factor (BNDF) and 5-hydroxytryptamine (5-HT) in Alzheimer's disease (AD) patients with sleep disorder.Methods A total of 78 patients with AD admitted to our hospital from June 2018 to July 2020 were selected. According to the Pittsburgh Sleep Quality Index (PSQI) scale, the patients were divided into a group with sleep disorder (n = 42) and the other group without sleep disorder (n = 36). Meanwhile, another 50 healthy individuals undergoing physical examination in our hospital during the same period were selected as the healthy group. The distribution of ApoE allele in each group was identified, and the levels of blood lipids, inflammatory factors and molecules associated with depression were compared between the ApoE4 carriers and ApoE4 non-carriers among the AD patients with sleep disorders.Results There was no difference in the frequency of ApoE2 and ApoE3 allele among the healthy individuals, the AD patients with sleep disorder and those without sleep disorder (P > 0.05). The frequency of ApoE4 allele was higher in AD patients with sleep disorder compared with the other two groups (P < 0.05), whereas there was no difference in the frequency of ApoE4 allele between the healthy group and the AD group without sleep disorder (P > 0.05). The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) in ApoE4 carriers were higher than those in ApoE4 non-carriers among the AD patients with sleep disorders (P < 0.05), while the levels of BNDF and 5-HT in ApoE4 carriers were lower than those in ApoE4 non-carriers (P < 0.05).Conclusions Sleep disorder in AD patients is associated with ApoE gene polymorphism, in which ApoE4 plays a dominant role potentially through the regulation of the levels of blood lipids, inflammatory factors and molecules associated with depression.