Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2021; 9(5): 1005-1015
Published online Feb 16, 2021. doi: 10.12998/wjcc.v9.i5.1005
Metabolic syndrome, ApoE genotype, and cognitive dysfunction in an elderly population: A single-center, case-control study
Jie-Yu Wang, Li Zhang, Jia Liu, Wei Yang, Li-Na Ma
Jie-Yu Wang, Li Zhang, Jia Liu, Wei Yang, Li-Na Ma, Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, Beijing 100053, China
Author contributions: Wang JY, Zhang L, Liu J, and Yang W conceived and designed the research; Zhang L and Liu J collected data and conducted research; Wang JY, Yang W, and Ma LN analyzed and interpreted data; Wang JY and Yang W wrote the initial paper; Yang W and Ma LN revised the paper; Wang JY had primary responsibility for final content; All authors read and approved the final manuscript.
Supported by Basic and Clinical Cooperation Project of Capital Medical University, No. 16JL82.
Institutional review board statement: The protocol for the study was approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University, No. [2108]112. All procedures performed in studies involving human participants were in accordance with the ethics standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethics standards.
Informed consent statement: Written informed consent was obtained from all subjects included in the study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Yang, MD, Chief Doctor, Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Medicine, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. yangw_79@163.com
Received: September 7, 2020
Peer-review started: September 7, 2020
First decision: December 3, 2020
Revised: December 12, 2020
Accepted: December 22, 2020
Article in press: December 22, 2020
Published online: February 16, 2021
Abstract
BACKGROUND

Metabolic syndrome (MetS) is related to poor cognitive function. However, the results of previous studies were inconsistent, and whether the ApoEε4 allele modifies the association remains unclear.

AIM

To elucidate the relationships among MetS, ApoEε4, and cognitive dysfunction in an elderly population in China.

METHODS

One hundred elderly patients with MetS and 102 age- and gender-matched controls were included in the study. Baseline clinical characteristics and biochemical index for glucose and lipid metabolism were obtained. The distribution of ApoEε4 was assessed with PCR restriction fragment length polymorphism analysis. Cognitive function was evaluated by mini-mental status examination at the 1-year follow-up examination.

RESULTS

Compared with controls, MetS patients had worse cognitive function and decreased ability to participate in activities of daily life (P = 0.001 and 0.046, respectively). Patients with cognitive dysfunction had higher prevalence of MetS (62.1% vs 36.4%, P < 0.001) and were more likely to carry the ApoEε4 allele (22.3% vs 10.1%, P = 0.019). Multivariate logistic regression analyses showed that diagnosis with MetS, severe insulin resistance, status as an ApoEε4 carrier, higher systolic blood pressure, and larger waist circumference were risk factors for cognitive dysfunction (P < 0.05). Repeated-measures analysis of variance, performed with data collected at the 1-year follow-up, revealed continuous influences of MetS and ApoEε4 on the deterioration of cognitive function (time × team, P < 0.001 for both).

CONCLUSION

Diagnosis of MetS and ApoEε4 carrier status were persistently associated with cognitive dysfunction among an elderly population in China.

Keywords: Metabolic syndrome, ApoEε4, Cognitive dysfunction, Elderly, Genotype, Case-control study

Core Tip: A case-control study was performed to evaluate the association between metabolic syndrome (MetS), ApoEε4, and cognitive dysfunction in an elderly population. With a multivariate analysis, we found that both MetS and status as an ApoEε4 carrier were risk factors for cognitive dysfunction. Moreover, with repeated-measures analysis of variance performed with data collected at the 1-year follow-up, we found continuous influences of MetS and ApoEε4 on the deterioration of cognitive function. These findings suggested that MetS and ApoEε4 carrier status were persistently associated with cognitive dysfunction among an elderly population.