Relation of Apolipoprotein(a) Size to Alzheimer’s Disease and Vascular Dementia

Vol. 18, No. 2, 2004

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Original Research Article

Relation of Apolipoprotein(a) Size to Alzheimer's Disease and Vascular Dementia
Enzo Emanuele^a, Emmanouil Peros^a,b, Carmine Tomaino^d, Enrica Feudatari^e, Livia Bernardi^d, Giuliano Binetti^e, Raffaele Maletta^d, Giuseppe Micieli^c, Amalia C. Bruni^d, Diego Geroldi^a,b

^aMolecular Medicine Laboratory,
^bDepartment of Internal Medicine and Medical Therapeutics, IRCCS Policlinico San Matteo, and
^cDepartment of Neurology, IRCCS Casimiro Mondino, University of Pavia, Pavia;
^dRegional Center of Neurogenetics, AS6, Lamezia Terme;
^eMemory Clinic and Neurobiology Laboratory, IRCCS Centro San Giovanni di Dio, FBF, Brescia, Italy

Address of Corresponding Author

Dement Geriatr Cogn Disord 2004;18:189-196 (DOI: 10.1159/000079200)

Key Words

Lipoprotein(a)
Apolipoprotein(a)
Post-stroke dementia

Abstract

Lipoprotein(a) [Lp(a)] level is a newly established vascular risk factor which has been suggested to play a role in dementia. However, the majority of Lp(a) cell-to-cell interactions are mediated by its specific apolipoprotein(a) [apo(a)] moiety. This suggests that the size polymorphism of apo(a) may be of importance in conveying the Lp(a)-related risk. Specifically, we postulated that variation in apo(a) isoform size may lead to increased risk of vascular dementia (VaD), Alzheimer's disease (AD), stroke, or all three of them. Under a case-control design we compared Lp(a) plasma levels and the distribution of apo(a) phenotypes in groups of subjects consisting of 50 VaD patients, 162 sporadic AD patients, 95 non-demented stroke patients (NDS), and 105 normal controls. The prevalence of small-sized apo(a) isoforms in the VaD group was significantly higher than that in the stroke and normal control groups, with an odds ratio of 5.29 (95% CI 2.24-12.49, p = 0.0001) for the development of VaD for individuals with at least one apo(a) isoform of low molecular weight (LMW). Furthermore, the possession of at least one small-sized apo(a) isoform significantly increased the risk of AD to 1.92 (95% CI 1.02-3.61, p = 0.0434). Our results demonstrate that possession of at least one LMW apo(a) isoform is significantly associated with dementia and specifically offer new evidence of a strong association between the lipoprotein system and post-stroke dementia.

Author Contacts

Diego Geroldi, MD
Department of Internal Medicine and Medical Therapeutics
IRCCS Policlinico San Matteo, University of Pavia
Piazzale Golgi, 2, IT-27100 Pavia (Italy)
Tel. +39 0382 502 568, Fax +39 0382 526 259, E-Mail d.geroldi@smatteo.pv.it

Article Information

Accepted: January 22, 2004
Published online: June 21, 2004
Number of Print Pages : 8
Number of Figures : 3, Number of Tables : 2, Number of References : 48

Medline Abstract (ID 15211075)

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