| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
4 is associated with obstructive sleep apnea/hypopnea
From Boston University School of Medicine and VA Boston Healthcare System (Dr. Gottlieb), MA; Boston University School of Public Health (Dr. DeStefano), MA; National Institute on Aging (D.J. Foley), Bethesda, MD; Stanford University (Dr. Mignot), CA; Case Western Reserve University (Dr. Redline), Cleveland, OH; University of Pittsburgh (Dr. Givelber), PA; and University of Wisconsin-Madison (Dr. Young).
Address correspondence and reprint requests to Dr. Daniel J. Gottlieb, The Pulmonary Center, Boston University School of Medicine, 715 Albany Street, R-304, Boston, MA 02118-2394; e-mail: dgottlieb{at}lung.bumc.bu.edu
Background: Obstructive sleep apnea/hypopnea (OSAH) has a strong heritable component, although its genetic basis remains largely unknown. One epidemiologic study found a significant association between the APOE 
4 allele and OSAH in middle-aged adults, a finding that was not replicated in a cohort of elderly adults. The objective of this study was to further examine the association of the APOE 4 allele with OSAH in a community-dwelling cohort, exploring age dependency of the association.
Methods: A genetic association study was performed, nested within a prospective cohort study of the cardiovascular consequences of OSAH. Unattended, in-home nocturnal polysomnography was used to measure apnea-hypopnea index (AHI) in 1,775 participants age 40 to 100 years. OSAH was defined as an AHI 
15. The relation of APOE genotype to prevalent OSAH was analyzed using generalized estimating equations to account for non-independent observations of individuals from the same sibship.
Results: At least one APOE 4 allele was present in 25% of subjects, with 1.3% 4/4 homozygotes. The prevalence of OSAH was 19%. After adjustment for age, sex, and BMI, the presence of any APOE 4 allele was associated with increased odds of OSAH (OR 1.41, 95% CI 1.06 to 1.87, p = 0.02). The effect was approximately twice as great in subjects <75 (OR 1.61, CI 1.02 to 2.54) as in those 75 years old (OR 1.32, CI 0.91 to 1.90). Exploratory analyses revealed that the strongest effect of APOE 4 was in subjects age <65 (OR 3.08, CI 1.43 to 6.64), and was stronger in those with hypertension or cardiovascular disease than in those without.
Conclusion: The APOE 4 allele is associated with increased risk of OSAH, particularly in individuals under age 65. The mechanisms underlying this association are uncertain. Age-dependency of the APOE-OSAH association may explain previous conflicting results.
Received November 14, 2003. Accepted in final form April 26, 2004.
This article has been cited by other articles:
|
|
 |
|
  R. L. Riha, T. Gislasson, and K. Diefenbach The phenotype and genotype of adult obstructive sleep apnoea/hypopnoea syndrome Eur. Respir. J., March 1, 2009; 33(3): 646 - 655. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Y. Avidan Sleep and Neurodegenerative Disorders ACCP Sleep Med Brd Rev, January 1, 2009; 4(0): 27 - 44. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Parish Genetic and Immunologic Aspects of Sleep Disorders ACCP Sleep Med Brd Rev, January 1, 2009; 4(0): 271 - 286. [Full Text] [PDF]
|
|
|
|
 |
|
 O. S. Capdevila, L. Kheirandish-Gozal, E. Dayyat, and D. Gozal Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-term Outcomes Proceedings of the ATS, February 15, 2008; 5(2): 274 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Caselli and R. Yaari Medical Management of Frontotemporal Dementia American Journal of Alzheimer's Disease and Other Dementias, January 1, 2008; 22(6): 489 - 498. [Abstract] [PDF]
|
|
|
|
 |
|
 D. Gozal, O. S. Capdevila, L. Kheirandish-Gozal, and V. M. Crabtree APOE {varepsilon}4 allele, cognitive dysfunction, and obstructive sleep apnea in children Neurology, July 17, 2007; 69(3): 243 - 249. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Mahley, K. H. Weisgraber, and Y. Huang Inaugural Article: Apolipoprotein E4: A causative factor and therapeutic target in neuropathology, including Alzheimer's disease PNAS, April 11, 2006; 103(15): 5644 - 5651. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. I. Pack Advances in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 7 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O'Hara, C. M. Schroder, H. C. Kraemer, N. Kryla, C. Cao, E. Miller, A. F. Schatzberg, J. A. Yesavage, and G. M. Murphy Jr Nocturnal sleep apnea/hypopnea is associated with lower memory performance in APOE {varepsilon}4 carriers Neurology, August 23, 2005; 65(4): 642 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Is the APOE {epsilon}4 Allele Associated with Obstructive Sleep Apnea/Hypopnea? Journal Watch Neurology, February 11, 2005; 2005(211): 6 - 6. [Full Text]
|
|
|
|
|
|
L. Lin, L. Finn, J. Zhang, T. Young, and E. Mignot Angiotensin-converting Enzyme, Sleep-disordered Breathing, and Hypertension Am. J. Respir. Crit. Care Med., December 15, 2004; 170(12): 1349 - 1353. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
