title: Meta-analysis of apolipoprotein E levels in the cerebrospinal fluid of patients with Alzheimer's disease.
abstract: The possible association between Apolipoprotein E (ApoE) levels in the cerebrospinal fluid (CSF) and Alzheimer's disease (AD) has been studied extensively. However, previous findings have been inconsistent. We conducted a meta-analysis of observational studies, seeking to provide insights into ApoE's potential as a biomarker for AD. A systematic literature search of PubMed (MEDLINE), EMBASE, and Web of Science was performed to retrieve relevant studies evaluating ApoE levels in CSF from AD subjects and controls. The association between ApoE levels in the CSF and AD was estimated by the weighted mean difference (WMD) and 95% confidence interval (CI) using a random-effect model. We identified 24 studies that included 1064AD cases and 1338 non-demented controls. Although the pooled WMD did not indicate a significant association between AD and ApoE levels (-0.30mg/l; 95% CI: -0.69 to 0.09; P=0.13), sub-group analysis controlling for patient sample size (n≥43) revealed significantly lower ApoE levels (WMD: -0.66mg/l; 95% CI: -1.02 to -0.31; P=0.0002) among patients with AD than in controls. Publication bias was absent and sensitivity analysis did not result in any significant change in the pooled estimates, indicating highly stable results. The present meta-analysis indicates the potential of CSF ApoE levels as a predictor of AD association.
authors.affiliation: Academy of Scientific and Innovative Research (AcSIR), CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB) Campus, New Delhi, India; Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Delhi, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Talwar
authors.affiliation: Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Delhi, India.
authors.forename: Juhi
authors.initials: J
authors.lastname: Sinha
authors.affiliation: Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Delhi, India; Department of Paediatrics, Division of Pneumonology-Immunology, Charité University Medical Centre, Berlin, Germany.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grover
authors.affiliation: Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India.
authors.forename: Rachna
authors.initials: R
authors.lastname: Agarwal
authors.affiliation: Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Kushwaha
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: M V Padma
authors.initials: MV
authors.lastname: Srivastava
authors.affiliation: Academy of Scientific and Innovative Research (AcSIR), CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB) Campus, New Delhi, India; Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Delhi, India. Electronic address: ritus@igib.res.in.
authors.forename: Ritushree
authors.initials: R
authors.lastname: Kukreti
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid*; D001057:Apolipoproteins E / Q000134:cerebrospinal fluid*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D006801:Humans
chemical_list: D001057:Apolipoproteins E; D015415:Biomarkers
keywords: Alzheimer's disease; Apolipoprotein E; Cerebrospinal fluid; Meta-analysis; Systematic review