Comparison of apolipoprotein E polymorphism and other atherosclerotic risk factors in two portuguese populations: the influence of insularity

The main objective of this study was to investigate the apolipoprotein (apo) E genotypes in Portuguese populations from mainland (Lisbon city) and from San Miguel Island, Azores' Archipelago (Ponta Delgada city) and to look for differences between these particular sites in apparently healthy subjects. Also, subjects with clinical diagnosis of atherosclerotic disease were investigated in San Miguel Island. In Lisbon, the genotypes distribution was: epsilon3/epsilon 3 > epsilon 3/epsilon 4 > epsilon 2/epsilon 3 > epsilon 4/epsilon 4 while that, for Ponta Delgada and regardless the health condition, was: epsilon 3/epsilon 3 > epsilon 2/epsilon 3 > epsilon 3/epsilon 4. Within Ponta Delgada control group, females and males had distinct genotype frequencies. The most common atherosclerotic risk factors as body mass index, blood hypertension and serum lipid parameters, presented some differences among the allelic subgroups of apo E. The major conclusions were: 1) an apparent influence of insularity in apo E polymorphism was observed; 2) both the high risk genotypes epsilon 2/epsilon 2 and epsilon 2/epsilon 4 were not found, even in patients; 3) curiously, the genotypes proportion in females was not homogenous among the three groups.

O principal objectivo deste estudo é o de pesquisar o efeito da insularidade nos polimorfismos da apolipoproteína (apo) E em indivíduos saudáveis do continente (Lisboa) e de Ponta Delgada (Ilha de S. Miguel, Arquipélago dos Açores). Adicionalmente, estudar a distribuição dos seus genótipos em doentes com aterosclerose da Ilha de S. Miguel. Em Lisboa, a distribuição dos genótipos da apo E foi a seguinte: épsilon3/épsilon3 > épsilon3/épsilon4 > épsilon2/épsilon3 > épsilon4/épsilon 4, ao passo que em Ponta Delgada e independentemente da condição fisiológica foi: épsilon 3/épsilon 3 > épsilon 2/épsilon 3 > épsilon 3/épsilon 4. Distintas frequências genotípicas foram observadas entre homens e mulheres no grupo saudável de Ponta Delgada. O índice de massa corporal, hipertensão arterial e perfil lipídico, factores de risco associados ao processo aterosclerótico, revelaram algumas diferenças quando avaliados em função dos grupos alélicos. Neste estudo, os genótipos de risco da apo E, épsilon2/épsilon2 e épsilon2/épsilon4, não foram contabilizados. Curiosamente a proporção dos genótipos nas mulheres foi heterogénea nos 3 grupos estudados.

Relevance of apolipoprotein E4 for the lipid profile of Brazilian patients with coronary artery disease

Apolipoprotein E (apoE - e2, e3, e4 alleles) plays a role in the regulation of lipid metabolism, with the e4 considered to be a risk factor for coronary artery disease (CAD). We aimed to evaluate the apoE polymorphisms in Brazilians with CAD and their influence on the lipid profile and other risk factors (hypertension, diabetes mellitus, smoking). Two hundred individuals were examined: 100 patients with atherosclerosis confirmed by coronary angiography and 100 controls. Blood samples were drawn to determine apoE polymorphisms and lipid profile. As expected, the e3 allele was prevalent in the CAD (0.87) and non-CAD groups (0.81; P = 0.099), followed by the e4 allele (0.09 and 0.14, respectively; P = 0.158). The e3/3 (76 and 78 percent) and e3/4 (16 and 23 percent) were the most common genotypes for patients and controls, respectively. The lipid profile was altered in patients compared to controls (P < 0.05), independently of the e4 allele. However, in the controls this allele was prevalent in individuals with elevated LDL-cholesterol levels only (odds ratio = 2.531; 95 percent CI = 1.028-6.232). The frequency of risk factors was higher in the CAD group (P < 0.05), but their association with the lipid profile was not demonstrable in e4 carriers. In conclusion, the e4 allele is not associated with CAD or lipid profile in patients with atherosclerosis. However, its frequency in the non-CAD group is associated with increased levels of LDL-cholesterol, suggesting an independent effect of the e4 allele on lipid profile when the low frequency of other risk factors in this group is taken into account.

Apolipoprotein E polymorphism in Brazilian dyslipidemic individuals: Ouro Preto study

The influence of apolipoprotein E alleles and genotypes on plasma lipid levels was determined in 185 individuals of mixed ethnicity living in Ouro Preto, Brazil. DNA was obtained from blood samples and the genotypes were determined by an RFLP-PCR procedure. The *3 allele was the most frequent (72 percent), followed by *4 (20 percent) and *2 (8 percent); *4 frequency was higher and *2 frequency was lower in the dyslipidemic group than in the normal control group. The *2 carriers presented lower LDL and total cholesterol levels compared to the *3 and *4 carriers. All six expected genotypes were observed in the individuals genotyped: E2/2 (2.1 percent), E4/4 (2.7 percent), E2/4 (3.7 percent), E2/3 (8.0 percent), E3/3 (53.3 percent), E3/4 (29.9 percent); no difference in genotype frequencies was found between the normal and dyslipidemic groups. Compared with *2, the presence of *3 increases more than two times the risk for dyslipidemia (OR = 2.31; P = 0.025; 95 percent CI = 1.06-5.06) and the presence of *4 increases it three times (OR = 3.31; P = 0.006; 95 percent CI = 1.36-8.04). The only significant effect of genotype was an increased risk for dyslipidemia in the *4 genotype carriers (E3/4 + E4/4) compared with the *2 genotype carriers (E2/2 + E2/3) with OR = 3.69 (95 percent CI = 1.25-10.88). The present study indicates that in the Ouro Preto admixed population the presence of APOE *2 can confer a protective effect, whereas the presence of APOE *4 implies an enhanced risk for dyslipidemia.