Association of APOE Gene Variants with Cognitive Dysfunction in Polycystic Ovary Syndrome
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Objective: To investigate the relationship between APOE polymorphisms and cognitive function in PCOS women and identify potential genetic biomarkers for cognitive risk stratification.
Methods and Materials: This cross-sectional study included 120 women with PCOS. Hormonal profiling (FSH, LH, total and free testosterone), metabolic parameters (insulin, HbA1c, HOMA-IR), and cognitive assessment using Montreal Cognitive Assessment (MoCA) were performed. APOE gene polymorphisms were analyzed to determine epsilon genotypes. Statistical analyses were performed by using SPSS software version 25.0 (SPSS, Chicago). Continuous data were presented as mean and standard deviation, and analyzed with Student t-test. Categorical variables were expressed as number and percentage and analyzed with Chi-square test. Binary logistic regression was used to determine the association between APOE gene polymorphism and cognitive impairment.
Findings: PCOS patients with cognitive impairment were older with lower educational levels, demonstrating significantly higher testosterone, insulin levels, and HOMA-IR values. MoCA cognitive domains showed significant impairment. APOE epsilon genotype analysis revealed significant associations with cognitive status (p=0.022). The ε3ε3 genotype was more prevalent in cognitively intact PCOS, while ε2ε3 and ε3ε4 genotypes were significantly more frequent in cognitively impaired PCOS (p=0.030 and p=0.040, respectively). ε2ε3 carriers had 3.61-fold increased odds of cognitive impairment (95% CI: 1.14-11.5), while ε3ε4 carriers had 3.05-fold increased risk (95% CI: 1.05-8.81) compared to ε3ε3 carriers.
Conclusion: This study demonstrates significant associations between APOE polymorphisms and cognitive function in PCOS patients. Both ε2ε3 and ε3ε4 genotypes confer increased cognitive impairment risk, while ε3ε3 appears protective. APOE genotyping could serve as a valuable tool for cognitive risk stratification in PCOS management after further validation.
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