Key result
ACE D/D genotype links to more severe deep white matter hyperintensities in dementia patients.
Why the study?
Is the ACE deletion/insertion polymorphism associated with the severity of white matter hyperintensities in patients with dementia?
Observational (n=97)
Is the ACE deletion/insertion polymorphism associated with the severity of white matter hyperintensities in patients with dementia?
p-value: p=.005
The ACE D/D genotype is associated with increased severity of deep white matter hyperintensities in patients with dementia, independent of cardiovascular risk factors.
ACE D/D genotype was associated with deeper WMH severity in dementia; leaves open independent genetic contribution pending larger confirmatory studies.
OBJECTIVES: To examine the association between the angiotensin-converting enzyme (ACE) deletion/insertion (D/I) polymorphism and white matter hyperintensities (WMHs) in patients with dementia. DESIGN: Observational pilot study with adjustment for potential confounders using analysis of covariance. SETTING: Secondary care old-age psychiatry services in greater Manchester, United Kingdom. PARTICIPANTS: Ninety-seven patients with dementia: 49 with Alzheimer's disease (AD, National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria) and 48 with vascular dementia (VaD, National Institute of Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences criteria). MEASUREMENTS: The ACE D/I polymorphism, WMHs (deep WMHs (DWMHs) and periventricular hyperintensities (PVHs)) on T2-weighted magnetic resonance imaging, and potential cardiovascular confounders. RESULTS: The D/D polymorphism of the ACE genotype was associated with severity of DWMH (P = .005) but not PVH (P = .34), corrected for age, cardiovascular risk factors, and type of dementia. Post hoc analyses were limited by statistical power but suggested an interaction with the apolipoprotein E epsilon4 allele. CONCLUSION: The results support previous observations that genetic factors influence the development of WMHs in dementia. The involvement of the ACE D/I polymorphism in the pathogenesis of DWMHs in dementia (AD and VaD), by a mechanism that is independent of its association with cardiovascular risk factors, should be confirmed in a large population-based sample.
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Purandare et al. (2006) conducted an observational in Dementia (Alzheimer's disease and vascular dementia) (n=97). ACE D/I polymorphism (D/D genotype) was evaluated on Severity of deep white matter hyperintensities (DWMHs) (p=.005). The D/D polymorphism of the ACE genotype was associated with severity of deep white matter hyperintensities (P = .005) but not periventricular hyperintensities (P = .34) in dementia patients.
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