[Effects of the apolipoprotein E polymorphism on plasma lipid levels and cardiovascular disease risk in a Mediterranean population]. / Efecto del polimorfismo de la apolipoproteína E en el perfil lipoproteico y riesgo cardiovascular en una población mediterránea.

ABSTRACT

BACKGROUND: Association of apolipoprotein E (apo E) polymorphism with atherosclerosis varies among populations. Our aim was to estimate the association of common apo E variants (epsilon2, epsilon3 and epsilon4 alleles) with plasma lipid concentrations and cardiovascular disease (CAD) risk in a Spanish Mediterranean population. PATIENTS AND METHOD: This was a cross-sectional study in 486 subjects (144 men and 342 women)from a general Mediterranean population (7-85 years). Apo E genotypes,anthropometric, biochemical and life-style variables were determined. RESULTS: Frequency of epsilon2 and epsilon4 alleles was low (0.052; 95% CI, 0.038-0.066, and 0.063; 95% CI,0.048-0.078, respectively). Apo E polymorphism was associated (p = 0.016) with LDL-C concentrations (119.9; 138.1 and 146.6 mg/dl in carriers of the epsilon2, epsilon3/epsilon3,and epsilon4 alleles, respectively). These differences remained significant (p = 0.017) after adjustment for gender, age and life-style factors. Subjects carrying the epsilon2 allele had higher triglyceride concentrations than non-carriers (p = 0.019). Prevalence of CAD was 14.0% in epsilon4 carriers, 6.9% in epsilon2 carriers and 3.4% in epsilon3/epsilon3 homozygotes. The higher risk of CAD associated with the epsilon4 allele remained significant (OR = 5.88; 95% CI, 1.64-21.02) after adjustment for gender, age and life-style factors. CONCLUSIONS: In the Spanish Mediterranean population, epsilon4 allele was associated with higher LDL-C concentrations and with a higher risk of CAD.