Choi K H, Song H Y, Shin S K, Noh H, Kang S W, Kim J H, Lee H Y, Han D S
Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.
Adv Perit Dial. 1999;15:243-6.
Apolipoprotein (Apo) E has an important role in triglyceride (TG)-rich lipoprotein metabolism, and the genotype of Apo E is associated with premature coronary artery disease. Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) develop various abnormalities of lipid metabolism and are prone to develop accelerated atherosclerosis. To investigate the distribution of Apo E genotype, and to evaluate the influence of Apo E polymorphism on lipid metabolism in CAPD patients, we measured Apo E genotypes, serum lipid, and lipoprotein levels in 54 CAPD patients (M:F = 1:1). The most common genotype of Apo E in the CAPD patients was E 3/3, found in 68.5%. The frequencies of the other genotypes were E 2/3, found in 14.8%, and E 4/3, found in 16.7%. No genotypic differences in Apo E were seen in the patients with regard to the presence of diabetes, the level of parathyroid hormone, or the transport characteristics of the peritoneal membrane. When comparing lipid levels by Apo E genotype, the total cholesterol and TG levels of E 2/3 patients were significantly higher than those of E 3/3 or E 4/3 patients. The differences in high-density or low-density lipoprotein cholesterol levels by Apo E genotype were not significant. In comparing lipoprotein levels by Apo E genotype, the Apo B and lipoprotein (a) levels of E 2/3 patients were significantly lower than those of E 3/3 or E 4/3 patients. In conclusion, the Apo E 3/3 genotype seems to be the most common genotype in CAPD patients, and the Apo E 2/3 genotype appears to be associated with high cholesterol and TG levels. These results demonstrate the need for further prospective studies in these subjects aimed at elucidating the impact of genetic variation at the Apo E locus on the development of atherosclerosis.
载脂蛋白（Apo）E在富含甘油三酯（TG）的脂蛋白代谢中起重要作用，且Apo E基因型与早发性冠状动脉疾病相关。接受持续性非卧床腹膜透析（CAPD）的患者会出现各种脂质代谢异常，且易于发生加速性动脉粥样硬化。为了研究Apo E基因型的分布，并评估Apo E多态性对CAPD患者脂质代谢的影响，我们测定了54例CAPD患者（男:女 = 1:1）的Apo E基因型、血脂和脂蛋白水平。CAPD患者中最常见的Apo E基因型是E 3/3型，占68.5%。其他基因型的频率分别为：E 2/3型，占14.8%；E 4/3型，占16.7%。在患者中，就糖尿病的存在、甲状旁腺激素水平或腹膜的转运特性而言，未发现Apo E基因型有差异。按Apo E基因型比较血脂水平时，E 2/3型患者的总胆固醇和TG水平显著高于E 3/3型或E 4/3型患者。Apo E基因型在高密度或低密度脂蛋白胆固醇水平上的差异不显著。按Apo E基因型比较脂蛋白水平时，E 2/3型患者的Apo B和脂蛋白（a）水平显著低于E 3/3型或E 4/3型患者。总之，Apo E 3/3基因型似乎是CAPD患者中最常见的基因型，而Apo E 2/3基因型似乎与高胆固醇和TG水平相关。这些结果表明有必要对这些受试者进行进一步的前瞻性研究，以阐明Apo E基因座的基因变异对动脉粥样硬化发展的影响。
