| Objective: To find out the situlation and distribution characteristics of Alzheimer's disease among the middle-aged and elderly population in Xinjiang Uygur and Han nationalities,and furthermore,to explore the polymorphism change with APOE,A2M genes and the changes of AD genotype and allele frequency in different ethnic groups, investigate the related AD factors,and additionally,to provide the initial value for intensive study on the pathogeny,prophylaxis and treatment of AD.Method: Adopt the combined methods of spot field and house-to-house investigation with stratified multi-stage cluster sampling according to the DSM-IV diagnostic criteria for dementia in USA and the United States language function disorders and Stroke Institute of AD and related diseases standards Association (NINCDS- ADRDA criteria). From July of 2004 to July of 2007,we randomly drew samples from the Xinjiang Uygur and Han nationalities above 50 from the 6 areas such as Bazhou Yanqi County and the surrounding seven counties and townships,Hotan Prefecture Moyu and Hotan county town and the surrounding six townships in southern Xinjiang;Turpan region southwest of the county town and surrounding nine rural towns in Eastern Xinjiang, the northern suburbs Bole area,the suburbs of the city, a total of 31 urban and township Changji Hui Autonomous Prefecture of Changji City and the surrounding village teams,Urumqi City Community. We carried a 1:2 case-control study according to the case group age and assess the socio-demographic factors,biological factors, family history etc to impact of the AD by univariate and multivariate non- conditional Logistic regression analysis. Based on epidemiological survey, we selected randomly 209 cases of sporadic AD patients whose average age is 74.2±12.6, 111 cases of Uygur and Han 98 cases were selected; we also selected 220 normal cases whoes the average age 73.8±13.1 years, with 117 cases of Uygur, 103 cases of Han. We analyzed the polymorphism change with APOE,A2M genes by polymerase chain reaction,and studied on the changes of AD genotype and allele frequency by the restriction fragment length polymorphism methods. Results: 1.A total of 8284 survey,Xinjiang AD the average AD crude prevalence rate is 3.66% among the 8284 samples,while the rate in Uygur and Han are 3.24% and 4.19% respectively. According to population composition by age in the 2000 nationwide census,the average AD standardized illness rate is 3.50%, the rates of Uygur and Han are 2.68% and 4.31% respectively; The crude prevalence rate in vascular dementia (VD)is 1.05%,the rates of Uygu and Han are 1.11% and 0.97%,Xinjiang VD standardized illness rate is 0.98%,the rates of Uygur and Han are 1.00% and 0.96% respectively; among AD samples, the crude prevalence rate of Uighur male and female are 2.54% and 3.93% respectively,while the age-adjusted standardized illness rate are 1.75% and 3.89%; The crude prevalence rate of Han male and female are 2.51% and 5.54%,the age-adjusted standardized illness rate are 2.17% and 6.26%. The prevalence rate of male and female has significance differences among every age group,and increase with age increasing. The AD prevalence rates among Uygur and Han obviously reduce with the increasing educational level. The survey found that AD prevalence rate in Uygur and Han nationalities has significance differences in different occupations,the housewife among Uighur and Han is suffering from the highest rate of AD,workers is the lowest one.2. In the related factors of AD study: Univariate analysis showed the relationship between AD and gender,brain trauma,alcohol history,head circumference,the sugar metabolization disorder,total cholesterol,low density lipoprotein (LDL) were statistically significant (P<0.05). Multivariate analysis showed that gender,brain trauma,the sugar metabolization disorder,higher total cholesterol have effect on the risk of AD,Longer head circumference,while lower the risk of AD.3. The gene polymorphism analysis indicated that the ApoE3/4 genotype distribution is different in the AD group and the control group,the AD group is 28.23%,the control group is 13.18%,the difference has statistics significance (P<0.05); But the ApoE3/3 genotype of control group is higher than the AD group obviously,the difference also has statistics significance (P<0.05); In Uygur,Hans different nationality,the ApoE3/4 genotype distribution and allele frequencies of ApoEε4 between the AD group and the control group have also significant (P<0.05); In Uygur,Hans different nationality,during different sex the comparison,the Uygur males ApoE3/4 genotype distributes in the AD group and the control group existence difference,but ApoEε4 the allele frequency separately has the difference in the Uygur and Han women female between AD group and the control group (P<0.05). 4. A2M gene polymorphism distribution is different in Uygur and Hans different nationality,The A2M genotype distribution displays the obvious nationality difference(P<0.05),and the Han crowd I/I genotype and the allele I frequency is higher than the Uygur national minority,but in the Uygur national minority crowd the I/V genotype and the allele V frequency is higher than the Han Nationality; during different sex A2M allele I and V frequency distribution has statistics significance (P<0.05),in the AD group of the Uygur,the highest females A2M allele V frequency is female, high, above.42%, the Han male is lowest 1.39%; while the Han men A2M I allele frequencies is up to98.61 %,the lowest for women Uygurs is 90.58%. Accompanied by ApoEε4 between the AD and the control group,A2M genotype and the allele frequency distribution have not statistics significance,but is not accompanied by ApoEε4 between the AD group and the control group,the I/V genotype of A2M gene distributes in the AD group to be higher than the control group,showed significance(P<0.05).Conclusion: 1. Xinjiang AD crude prevalence rate is 3.66%(standardized incidence is 3.50%), Uygur, Han AD Rough prevalence rates are 3.24% and 4.19% respectively(standardized incidence are 2.68%and 4.31%), the AD prevalence rates of Hans is higher than the Uygurs(P<0.05), there are significant differences among the nationality,gender,age,occupation and cultural.2.In risks analyses,the study demonstrated that gender, brain trauma,the sugar metabolization disorder,higher total cholesterol are risk factors for AD, longer head circumference may be one of protective risk factors. 3. The gene polymorphism analysis indicated the AD is closely related to the ApoE gene, and ApoE gene distributes differently in the AD group and the control group; carries the ApoE3/4 genotype and ApoEε4 the allele frequency is the risk factor AD,but between Uygur and Han different nationality, ApoE various genotypes and allele frequency difference were not statistically significant.4. The AD of Uygur and Han nationalities has relation with A2MI100V polymorphism, and A2M genotype and allele frequency distribution shows the nationality, gender differences,A2M might be independent from the ApoEε4 and have effect on occurrence of AD. |
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