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October 13, 2020; 95 (15) Article

Apolipoprotein E genotype and in vivo amyloid burden in middle-aged Hispanics

Priya Palta, Brady Rippon, Christiane Reitz, View ORCID ProfileHengda He, Greysi Sherwood, Fernando Ceballos, Jeanne Teresi, Qolamreza Razlighi, Herman Moreno, View ORCID ProfileAdam M. Brickman, José A. Luchsinger
First published August 26, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010707
Priya Palta
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Brady Rippon
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Christiane Reitz
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Hengda He
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Greysi Sherwood
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Fernando Ceballos
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Jeanne Teresi
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Qolamreza Razlighi
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Herman Moreno
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Adam M. Brickman
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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José A. Luchsinger
From the Department of Medicine (P.P., B.R., G.S., F.C., J.A.L.), Vagelos College of Physicians and Surgeons, Department of Epidemiology (P.P., C.R., J.A.L.), Joseph P. Mailman School of Public Health, Department of Neurology (C.R., H.H., Q.R., A.M.B.), College of Physicians and Surgeons, Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R., Q.R., A.M.B.), and Gertrude H. Sergievsky Center (C.R., Q.R., A.M.B.), Columbia University Irving Medical Center, New York; Research Division (J.T.), Hebrew Home in Riverdale, Bronx; Columbia University Stroud Center at New York State Psychiatric Center (J.T.); Department of Biomedical Engineering (Q.R.), Columbia University, New York; and Department of Neurology (H.M.), SUNY Downstate Medical Center, Brooklyn, NY.
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Citation
Apolipoprotein E genotype and in vivo amyloid burden in middle-aged Hispanics
Priya Palta, Brady Rippon, Christiane Reitz, Hengda He, Greysi Sherwood, Fernando Ceballos, Jeanne Teresi, Qolamreza Razlighi, Herman Moreno, Adam M. Brickman, José A. Luchsinger
Neurology Oct 2020, 95 (15) e2086-e2094; DOI: 10.1212/WNL.0000000000010707

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Abstract

Objective To examine in vivo amyloid burden in relation to APOEε4 genotype in middle-aged Hispanics. We hypothesize higher amyloid levels among APOE ε4 carriers vs APOE ε4 noncarriers.

Methods This is a cross-sectional study in a community-based sample of 249 middle-aged Hispanics in New York City who underwent a 3T brain MRI and PET with the amyloid radioligand 18F-florbetaben. APOE genotype was the primary exposure. The primary outcome was amyloid positivity. The secondary outcome was subthreshold amyloid levels examined as a continuous variable.

Results APOE ε4 carriers (n = 85) had a higher frequency (15.3%) of amyloid positivity compared to APOE ε4 noncarriers (n = 164, 1.8%). In the subthreshold group of amyloid-negative participants (n = 233), APOE ε4 carriers (n = 72) had a 0.02 (95% confidence interval [CI] 0.01–0.04) higher global brain amyloid standardized uptake value ratio (SUVR) compared to APOE ε4 noncarriers (n = 161). Compared to participants with the ε3/ε3 genotype, participants with ε4/ε4 had the highest frequency of amyloid positivity (28.6%), followed by those with ε3/ε4 (11%). Among amyloid-negative participants (n = 233), compared to participants with ε3/ε3 (n = 134), those with ε4/ε4 (n = 5) had a 0.12 (95% CI 0.07–0.17) higher global brain amyloid SUVR, and those with ε3/ε4 had a 0.02 higher SUVR (95% CI 0.003–0.04). Results were similar when a median split was used for elevated amyloid, when continuous amyloid SUVR was analyzed in all participants, and in nonparametric Mann-Whitney comparisons.

Conclusion Middle-aged Hispanic APOE ε4 carriers have higher in vivo brain amyloid burden compared with noncarriers, as reported in non-Hispanics.

Glossary

Aβ=
β-amyloid;
CI=
confidence interval;
HDL=
high-density lipoprotein;
LDL=
low-density lipoprotein;
LOAD=
late-onset Alzheimer disease;
SUV=
standardized uptake value;
SUVR=
SUV ratio

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 665

  • Received September 11, 2019.
  • Accepted in final form April 29, 2020.
  • © 2020 American Academy of Neurology
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