Does the Apolipoprotein ε4 Allele Predispose Varsity Athletes to Concussion? A Prospective Cohort Study

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Objective:To determine the association between the apolipoprotein ε4 allele and concussion. We hypothesized that apolipoprotein ε4 carriers may be more likely to sustain a concussion.Design:Prospective cohort study.Setting:University of Toronto varsity athletics.Participants:Included 318 of 822 collegiate student athletes who participated in University of Toronto varsity sports from September 2002 to April 2006.Assessment of Risk Factors:The presence of apolipoprotein ε4 was described dichotomously after genotyping blood samples collected from participants.Main Outcome Measurements:Concussions were identified by sport-medicine professionals present on the sidelines using on-field assessment forms. All concussion diagnoses were verified by a sports medicine physician. Survival analysis was used to determine the association between apolipoprotein ε4 and first concussion.Results:The unadjusted hazard ratio for concussion in the apolipoprotein ε4 carriers was 1.18 (95% CI: 0.52, 2.69) compared to noncarriers. Adjustment for sex, weight, height, and team type resulted in a hazard ratio of 1.06 (95% CI: 0.41, 2.72), indicating little effect from confounding factors.Conclusions:There is no important association between carrying the apolipoprotein ε4 allele and sustaining a concussion. At this time, we do not recommend preseason genetic testing for varsity athletes as a mechanism for targeting prevention strategies.

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