Clinical Information (ข้อมูลทางคลินิก):
Apolipoprotein E (APOE) is a key lipid transport protein, and its common alleles (ε2, ε3, ε4) influence risk for both late‑onset Alzheimer’s disease and atherosclerotic cardiovascular disease. The ε4 allele is associated with an increased relative risk and earlier average age of onset of late‑onset Alzheimer’s disease, whereas ε2 is generally considered protective compared with the reference ε3/ε3 genotype. In the cardiovascular setting, ε4 is typically associated with higher LDL‑cholesterol levels and increased susceptibility to ischemic heart disease and stroke, while ε2 may confer some protection against coronary artery disease but can predispose to dyslipidemia in certain individuals. APOE genotyping can therefore provide risk‑modifying information in patients with cognitive symptoms or a strong family history of dementia, and in selected patients with premature or unexplained atherosclerotic cardiovascular disease or complex lipid disorders, when interpreted alongside clinical, biochemical, and imaging findings. However, APOE status is neither necessary nor sufficient to diagnose Alzheimer’s disease or cardiovascular disease, and many ε4 carriers remain unaffected while disease can occur in non‑ε4 carriers; results should be used as one component of a multifactorial risk assessment and are best discussed within an appropriate counselling framework to avoid over‑ or mis‑interpretation.
Clinical Reference (เอกสารอ้างอิง):
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