Apolipoprotein E genotypes were not associated with intracranial atherosclerosis: a population-based autopsy study

•The APOE polymorphism was not associated with atherosclerosis in the 12 arteries of the Circle of Willis•Having at least one APOE-ε4 allele was not related to a high risk of intracranial atherosclerosis•Lower stenosis in older carriers of APOE-ε4 suggests the possibility of attrition bias Apolipopr...

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Published in:Cardiovascular pathology 2023-01, Vol.62, p.107479-107479, Article 107479
Main Authors: Paradela, Regina Silva, Farias-Itao, Daniela Souza, Leite, Renata E.P., Pasqualucci, Carlos A., Grinberg, Lea T., Naslavsky, Michel Satya, Zatz, Mayana, Nitrini, Ricardo, Jacob-Filho, Wilson, Suemoto, Claudia Kimie
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Apolipoprotein E
Apolipoproteins
Atherosclerosis
Autopsy
Cerebral arteries
Constriction, Pathologic
Cross-Sectional Studies
Epidemiology
Female
Humans
Intracranial Arteriosclerosis - genetics
Male
Middle Aged
Risk factors
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Summary:•The APOE polymorphism was not associated with atherosclerosis in the 12 arteries of the Circle of Willis•Having at least one APOE-ε4 allele was not related to a high risk of intracranial atherosclerosis•Lower stenosis in older carriers of APOE-ε4 suggests the possibility of attrition bias Apolipoprotein E gene (APOE) ε4 allele is associated with a higher risk of carotid atherosclerosis, but less is known about the association of APOE with intracranial atherosclerotic disease (IAD). We aimed to investigate the association of APOE alleles with IAD in a cross-sectional autopsy study. We measured the stenosis in the 12 arteries of the Circle of Willis using postmortem morphometric measurements. The APOE polymorphism was determined by real-time polymerase chain reaction. We assessed the association between APOE polymorphism and IAD using regression models adjusted for sociodemographic and clinical variables. We also verified the modifier effect of age, sex, and race on this association. We stratified the analysis by age group to investigate the possibility of attrition bias. In 400 participants (mean age=73.2±12.3 years old, 51% female, and 64% White), IAD was evaluated in 4,504 artery segments. APOE-ε4 was not associated with IAD nor with the number of artery stenosis compared to non-APOE-ε4 carriers. Sociodemographic variables did not modify this relationship. Among participants older than 70 years, there was a trend towards an association between APOE allele ε4 and a lower stenosis index in the middle cerebral artery, suggesting attrition bias related to the APOE-ε4 effect on mortality. APOE alleles were not associated with IAD in this population-based autopsy study. Lower stenosis in older participants suggests the possibility of attrition bias.
ISSN:1054-8807
1879-1336
DOI:10.1016/j.carpath.2022.107479