Apolipoprotein E ε4 Prevalence in Alzheimer’s Disease Patients Varies across Global Populations: A Systematic Literature Review and Meta-Analysis

Abstract

Background: The Ε4 allele of apolipoprotein E (APOE) is associated with Alzheimer’s disease (AD). However, attributable risk due to APOE4 varies by region and by race/ethnicity. Methods: A literature review and meta-analysis were conducted to estimate the prevalence of APOE4 by geographic area among AD patients. Results: Although estimates varied significantly by study design and case definition, AD patients recruited in Asian and southern European/Mediterranean communities seemed to have significantly lower E4 carrier status estimates (37 and 43%) than those recruited in North America (58%) or northern Europe (64%; all: p < 0.05). Conclusions: APOE4 genotype frequency varies among AD patients in regional patterns similar to that of the general population. Study level differences may also contribute to the heterogeneity of published estimates of APOE4 in AD cases.

Metabolic Risk Factors of Sporadic Alzheimer's Disease: Implications in the Pathology, Pathogenesis and Treatment

“…The polymorphism of APOE is considered as a definite risk factor for AD with ε4 allele (APOE4) showing strong association with the disease, but the estimated risk attributable to APOE4 varies in different populations depending on the frequency of this allele in a particular population [55]. The protein coded by APOE is apolipoprotein E which is involved in cholesterol transport in the periphery as well as cholesterol trafficking within the brain, and APOE genotype and serum total cholesterol interaction has been suggested in AD progression [56].…”

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

“…In a recent review and meta-analysis, E4 has been shown to be associated with about 65 to 75 percent of cases of non-Mendelian-inherited AD and up to 20 percent of all dementias (Crean et al, 2011). The meta-analysis found that 39 percent of AD patients from Asian countries carried the APOE4 allele, as did 43 percent of patients from southern Europe and the Mediterranean, 54 percent from central Europe, 59 percent from North America, and 64 percent from northern Europe.…”

“…Having one or two E4 alleles or forms of the APOE gene is a major predictor of AD, although the evidence is somewhat inconsistent for African Americans (Chin et al, 2011;Crean et al, 2011;Graff-Radford et al, 2002;Logue et al, 2011;Tang et al, 1996). The E4 allele is associated with increased risk of AD among African Americans, but not among Yoruba (Hendrie et al, 2006).…”

Стан Когнітивних Функцій У Пацієнтів Із Фібриляцією Передсердь Та Різним Генотипом Аполіпопротеїну Е

“…За наявності однієї алелі ε4 50 % жінок і чоловіків ризикують захво-ріти до 87 років [10]. Більш докладний метааналіз досліджень показав, що серед пацієнтів різної ра-сово-територіальної належності з ХА азіати і жи-телі Середземномор'я значно рідше були носіями ε4 (37 та 43 % відповідно), ніж хворі європеоїдного населення Північної Америки і Північної Європи (58 і 64 % відповідно; відмінності вірогідні між усі-ма групами; p < 0,05) [13].…”