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Disease Markers
Volume 2014, Article ID 724281, 7 pages
Research Article

A Disease Modification Effect of APOE E4 on the Association between Urinary Albumin Excretion and Cognition in Korean Adults

1Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
2Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Jeonbuk, Republic of Korea
3Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
4Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Jeonbuk, Republic of Korea
5Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Republic of Korea
6Department of Neurology & Research Institute of Clinical Medicine, Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, San 2-20, Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, Republic of Korea

Received 30 June 2014; Accepted 10 September 2014; Published 30 October 2014

Academic Editor: Claudio Letizia

Copyright © 2014 Min-Ho Shin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. No previous study examined a disease modifying effect of APOE E4 status on the association between the urinary albumin-to-creatinine ratio (UACR) and cognition. This study aimed to investigate whether APOE E4 modified the association in Korean adults. Methods. We performed a cross-sectional study in adults aged 45 to 74 who were living in Namwon City, Republic of Korea. Cognitive function was measured with the Korean version of modified Mini-Mental State Examination (K-mMMSE) and cognitive impairment was defined as scores falling below the 25th percentile of the K-mMMSE according to age, sex, and educational attainments. Results. A total of 10,190 participants (4006 men and 6184 women) were analyzed in the present study. Of these, 1698 subjects (16.7%) were APOE E4 carriers. The UACR values were negatively associated with the K-mMMSE scores, even after adjusting for potential confounders including age, sex, education, and vascular risk factors. APOE E4 modified the association significantly, resulting in a steeper decline of cognitive function with the increase in UACR in E4 carriers (P for interaction = 0.021). Conclusion. Higher UACR values were significantly associated with cognitive dysfunction in the general Korean population, with cognition in APOE E4 carriers being more severely affected by increased UACR.