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Vol. 17, No. 1, 1998
Issue release date: January–February 1998
Neuroepidemiology 1998;17:14–20

Serum Total Cholesterol, Apolipoprotein E {FC12}e4 Allele, and Alzheimer’s Disease

Notkola I.-L. · Sulkava R. · Pekkanen J. · Erkinjuntti T. · Ehnholm C. · Kivinen P. · Tuomilehto J. · Nissinen A.
a Department of Public Health and General Practice, University of Kuopio, Departments of b Environmental Medicine, c Biochemistry, and d Epidemiology and Health Promotion, National Public Health Institute, Helsinki, e Department of Neurology, University of Helsinki, Finland

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The σ4 allele of the apolipoprotein E (apoE) is associated with Alzheimer’s disease (AD) and also with elevated serum total cholesterol and low-density lipoprotein levels. However, the interrelationships between apoE genotype, plasma cholesterol levels and AD risk have been studied very little. We examined the possible role of serum total cholesterol in the pathogenesis of AD in a population-based sample of 444 men, aged 70–89 years, who were survivors of the Finnish cohorts of the Seven Countries Study. Previous high serum cholesterol level (mean level ≥6.5 mmol/l) was a significant predictor of the prevalence of AD (odds ratio = 3.1; 95% confidence interval = 1.2, 8.5) after controlling for age and the presence of apoE σ4 allele. In men who subsequently developed AD the cholesterol level decreased before the clinical manifestations of AD. We conclude that high serum total cholesterol may be an independent risk factor for AD and some of the effect of the apoE σ4 allele on risk of AD might be mediated through high serum cholesterol.

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