Linear relationship of apolipoprotein E genotypes with LDL cholesterol levels and coronary risk
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Previous studies have shown associations between common apolipoprotein E (apo E) gene polymorphisms (epsilon2, epsilon3, epsilon4), lipid levels and cardiovascular disease, but their results may be biased owing to their small sample sizes. To reassess associations of apoE genotypes with circulating lipid levels and with coronary risk, an updated meta-analysis including 82 studies of lipid levels and 121 studies of coronary outcomes was conducted. In the most extreme comparison, people with the epsilon2/epsilon2 genotype had 31% lower mean LDL-cholesterol levels than those with the epsilon4/epsilon4 genotype. Approximately linear relationships of apo E genotypes (when ordered epsilon2/epsilon2, epsilon2/epsilon3, epsilon2/epsilon4, epsilon3/epsilon3, epsilon3/epsilon4, epsilon4/epsilon4) with LDL-cholesterol levels and with coronary risk were found. The relationship with HDL-cholesterol was inverse, that with triglycerides was nonlinear and largely confined to the epsilon2/epsilon2 group. The authors conclude that epsilon2 carriers have a 20% lower risk and epsilon 4 carriers a slightly higher risk of coronary heart disease compared to the epsilon3/epsilon3 genotype.
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