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Deletion/Insertion Polymorphism of the Angiotensin‐Converting Enzyme Gene and White Matter Hyperintensities in Dementia: A Pilot Study
Author(s) -
Purandare Nitin,
Oude Voshaar Richard C.,
Davidson Yvonne,
Gibbons Linda,
Hardicre Jayne,
Byrne Jane,
McCollum Charles,
Jackson Alan,
Burns Alistair,
Mann David M. A.
Publication year - 2006
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2006.00841.x
Subject(s) - dementia , hyperintensity , medicine , vascular dementia , confounding , alzheimer's disease , stroke (engine) , psychiatry , apolipoprotein e , disease , magnetic resonance imaging , mechanical engineering , engineering , radiology
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 ɛ4 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.