The diagnostic value investigation of blood lipid as biomarker combined with apolipoprotein E genotype in dementia with Lewy bodies

Background The apolipoprotein E ε4 allele ( APOE ε4) is a genetic risk factor for neurodegenerative diseases. The potential of lipid metabolism as a biomarker in conjunction with APOE ε4 for the evaluation of dementia with Lewy bodies (DLB) warrants further investigation. Objective The study aimed to investigate the association between APOE ε4 and lipid metabolism in DLB. Methods This was a cross-sectional observational study that included a total of 171 DLB patients diagnosed based on established clinical consensus criteria. Strict inclusion and exclusion criteria were used in this study. APOE genotypes and blood lipid levels were determined using unified standards. IBM SPSS Statistics software was used for statistical analysis. Results In patients with mild and moderate CDR, APOE ε4 carriers had significantly higher CHOL and LDL-C levels compared to non-carriers. In the 70–79 age group, APOE ε4 carriers demonstrated higher LDL-C (2.94 ± 0.83 mmol/L versus 2.47 ± 0.97 mmol/L, q = 0.0480) and CHOL (4.88 ± 1.05 mmol/L versus 4.25 ± 1.18 mmol/L, q = 0.0453) levels compared to non-carriers. In the 70–79 age group, ROC curve analysis showed that TG (AUC = 0.65, 95%CI = 0.514–0.785, p = 0.046), LDL-C (AUC = 0.663, 95%CI = 0.526–0.801, p = 0.03) and CHOL (AUC = 0.692, 95%CI = 0.557–0.827, p = 0.011) had certain reference value for diagnosis. Among patients presenting with rapid eye movement sleep behavior disorder, fluctuating cognition, and parkinsonism, APOE ε4 carriers exhibited higher levels of APO B, CHOL, and LDL-C compared to non-carriers. Conclusions Peripheral blood lipid level as a metabolic biomarker, combined with APOE ε4 gene detection, has potential value for disease monitoring and prognosis evaluation.