Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology

Miguel Pappolla, T. K. Bryant-Thomas, D. Herbert, J. Pacheco, M. Fabra Garcia, M. Manjon, X. Girones, T. L. Henry, E. Matsubara, D. Zambon, B. Wolozin, M. Sano, F. F. Cruz-Sanchez, L. J. Thal, S. S. Petanceska, L. M. Refolo

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Abstract

Background: Epidemiologic and experimental data suggest that cholesterol may play a role in the pathogenesis of AD. Modulation of cholesterolemia in transgenic animal models of AD strongly alters amyloid pathology. Objective: To determine whether a relationship exists between amyloid deposition and total cholesterolemia (TC) in the human brain. Methods: The authors reviewed autopsy cases of patients older than 40 years and correlated cholesterolemia and presence or absence of amyloid deposition (amyloid positive vs amyloid negative subjects) and cholesterolemia and amyloid load. Amyloid load in human brains was measured by immunohistochemistry and image analysis. To remove the effect of apoE isoforms on cholesterol levels, cases were genotyped and duplicate analyses were performed on apoE3/3 subjects. Results: Cholesterolemia correlates with presence of amyloid deposition in the youngest subjects (40 to 55 years) with early amyloid deposition (diffuse type of senile plaques) (p = 0.000 for all apoE isoforms; p = 0.009 for apoE3/3 subjects). In this group, increases in cholesterolemia from 181 to 200 almost tripled the odds for developing amyloid, independent of apoE isoform. A logistic regression model showed consistent results (McFadden ρ2 = 0.445). The difference in mean TC between subjects with and without amyloid disappeared as the age of the sample increased (>55 years: p = 0.491), possibly reflecting the effect of cardiovascular deaths among other possibilities. TC and amyloid load were not linearly correlated, indicating that there are additional factors involved in amyloid accumulation. Conclusions: Serum hypercholesterolemia may be an early risk factor for the development of AD amyloid pathology.

Original languageEnglish (US)
Pages (from-to)199-205
Number of pages7
JournalNeurology
Volume61
Issue number2
StatePublished - Jul 22 2003
Externally publishedYes

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Hypercholesterolemia
Amyloid
Pathology
Apolipoproteins E
Apolipoprotein E3
Protein Isoforms
Logistic Models
Cholesterol
Genetically Modified Animals
Amyloid Plaques
Brain
Autopsy
Animal Models
Immunohistochemistry

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Pappolla, M., Bryant-Thomas, T. K., Herbert, D., Pacheco, J., Fabra Garcia, M., Manjon, M., ... Refolo, L. M. (2003). Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology. Neurology, 61(2), 199-205.

Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology. / Pappolla, Miguel; Bryant-Thomas, T. K.; Herbert, D.; Pacheco, J.; Fabra Garcia, M.; Manjon, M.; Girones, X.; Henry, T. L.; Matsubara, E.; Zambon, D.; Wolozin, B.; Sano, M.; Cruz-Sanchez, F. F.; Thal, L. J.; Petanceska, S. S.; Refolo, L. M.

In: Neurology, Vol. 61, No. 2, 22.07.2003, p. 199-205.

Research output: Contribution to journalArticle

Pappolla, M, Bryant-Thomas, TK, Herbert, D, Pacheco, J, Fabra Garcia, M, Manjon, M, Girones, X, Henry, TL, Matsubara, E, Zambon, D, Wolozin, B, Sano, M, Cruz-Sanchez, FF, Thal, LJ, Petanceska, SS & Refolo, LM 2003, 'Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology', Neurology, vol. 61, no. 2, pp. 199-205.
Pappolla M, Bryant-Thomas TK, Herbert D, Pacheco J, Fabra Garcia M, Manjon M et al. Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology. Neurology. 2003 Jul 22;61(2):199-205.
Pappolla, Miguel ; Bryant-Thomas, T. K. ; Herbert, D. ; Pacheco, J. ; Fabra Garcia, M. ; Manjon, M. ; Girones, X. ; Henry, T. L. ; Matsubara, E. ; Zambon, D. ; Wolozin, B. ; Sano, M. ; Cruz-Sanchez, F. F. ; Thal, L. J. ; Petanceska, S. S. ; Refolo, L. M. / Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology. In: Neurology. 2003 ; Vol. 61, No. 2. pp. 199-205.
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abstract = "Background: Epidemiologic and experimental data suggest that cholesterol may play a role in the pathogenesis of AD. Modulation of cholesterolemia in transgenic animal models of AD strongly alters amyloid pathology. Objective: To determine whether a relationship exists between amyloid deposition and total cholesterolemia (TC) in the human brain. Methods: The authors reviewed autopsy cases of patients older than 40 years and correlated cholesterolemia and presence or absence of amyloid deposition (amyloid positive vs amyloid negative subjects) and cholesterolemia and amyloid load. Amyloid load in human brains was measured by immunohistochemistry and image analysis. To remove the effect of apoE isoforms on cholesterol levels, cases were genotyped and duplicate analyses were performed on apoE3/3 subjects. Results: Cholesterolemia correlates with presence of amyloid deposition in the youngest subjects (40 to 55 years) with early amyloid deposition (diffuse type of senile plaques) (p = 0.000 for all apoE isoforms; p = 0.009 for apoE3/3 subjects). In this group, increases in cholesterolemia from 181 to 200 almost tripled the odds for developing amyloid, independent of apoE isoform. A logistic regression model showed consistent results (McFadden ρ2 = 0.445). The difference in mean TC between subjects with and without amyloid disappeared as the age of the sample increased (>55 years: p = 0.491), possibly reflecting the effect of cardiovascular deaths among other possibilities. TC and amyloid load were not linearly correlated, indicating that there are additional factors involved in amyloid accumulation. Conclusions: Serum hypercholesterolemia may be an early risk factor for the development of AD amyloid pathology.",
author = "Miguel Pappolla and Bryant-Thomas, {T. K.} and D. Herbert and J. Pacheco and {Fabra Garcia}, M. and M. Manjon and X. Girones and Henry, {T. L.} and E. Matsubara and D. Zambon and B. Wolozin and M. Sano and Cruz-Sanchez, {F. F.} and Thal, {L. J.} and Petanceska, {S. S.} and Refolo, {L. M.}",
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T1 - Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology

AU - Pappolla, Miguel

AU - Bryant-Thomas, T. K.

AU - Herbert, D.

AU - Pacheco, J.

AU - Fabra Garcia, M.

AU - Manjon, M.

AU - Girones, X.

AU - Henry, T. L.

AU - Matsubara, E.

AU - Zambon, D.

AU - Wolozin, B.

AU - Sano, M.

AU - Cruz-Sanchez, F. F.

AU - Thal, L. J.

AU - Petanceska, S. S.

AU - Refolo, L. M.

PY - 2003/7/22

Y1 - 2003/7/22

N2 - Background: Epidemiologic and experimental data suggest that cholesterol may play a role in the pathogenesis of AD. Modulation of cholesterolemia in transgenic animal models of AD strongly alters amyloid pathology. Objective: To determine whether a relationship exists between amyloid deposition and total cholesterolemia (TC) in the human brain. Methods: The authors reviewed autopsy cases of patients older than 40 years and correlated cholesterolemia and presence or absence of amyloid deposition (amyloid positive vs amyloid negative subjects) and cholesterolemia and amyloid load. Amyloid load in human brains was measured by immunohistochemistry and image analysis. To remove the effect of apoE isoforms on cholesterol levels, cases were genotyped and duplicate analyses were performed on apoE3/3 subjects. Results: Cholesterolemia correlates with presence of amyloid deposition in the youngest subjects (40 to 55 years) with early amyloid deposition (diffuse type of senile plaques) (p = 0.000 for all apoE isoforms; p = 0.009 for apoE3/3 subjects). In this group, increases in cholesterolemia from 181 to 200 almost tripled the odds for developing amyloid, independent of apoE isoform. A logistic regression model showed consistent results (McFadden ρ2 = 0.445). The difference in mean TC between subjects with and without amyloid disappeared as the age of the sample increased (>55 years: p = 0.491), possibly reflecting the effect of cardiovascular deaths among other possibilities. TC and amyloid load were not linearly correlated, indicating that there are additional factors involved in amyloid accumulation. Conclusions: Serum hypercholesterolemia may be an early risk factor for the development of AD amyloid pathology.

AB - Background: Epidemiologic and experimental data suggest that cholesterol may play a role in the pathogenesis of AD. Modulation of cholesterolemia in transgenic animal models of AD strongly alters amyloid pathology. Objective: To determine whether a relationship exists between amyloid deposition and total cholesterolemia (TC) in the human brain. Methods: The authors reviewed autopsy cases of patients older than 40 years and correlated cholesterolemia and presence or absence of amyloid deposition (amyloid positive vs amyloid negative subjects) and cholesterolemia and amyloid load. Amyloid load in human brains was measured by immunohistochemistry and image analysis. To remove the effect of apoE isoforms on cholesterol levels, cases were genotyped and duplicate analyses were performed on apoE3/3 subjects. Results: Cholesterolemia correlates with presence of amyloid deposition in the youngest subjects (40 to 55 years) with early amyloid deposition (diffuse type of senile plaques) (p = 0.000 for all apoE isoforms; p = 0.009 for apoE3/3 subjects). In this group, increases in cholesterolemia from 181 to 200 almost tripled the odds for developing amyloid, independent of apoE isoform. A logistic regression model showed consistent results (McFadden ρ2 = 0.445). The difference in mean TC between subjects with and without amyloid disappeared as the age of the sample increased (>55 years: p = 0.491), possibly reflecting the effect of cardiovascular deaths among other possibilities. TC and amyloid load were not linearly correlated, indicating that there are additional factors involved in amyloid accumulation. Conclusions: Serum hypercholesterolemia may be an early risk factor for the development of AD amyloid pathology.

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