Granér Marit, Kahri Juhani, Varpula Marjut, Salonen Riitta M, Nyyssönen Kristiina, Jauhiainen Matti, Nieminen Markku S, Syvänne Mikko, Taskinen Marja-Riitta
Department of Internal Medicine, Division of Cardiology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290 HUCH, Helsinki, Finland.
Nutr Metab Cardiovasc Dis. 2008 May;18(4):271-7. doi: 10.1016/j.numecd.2007.01.003. Epub 2007 Apr 26.
Apolipoprotein E (apoE) polymorphism plays a significant role in the development of atherosclerosis and cardiovascular disease. Therefore, the aim of the present study was to examine the association between apoE polymorphism and carotid intima-media thickness (IMT), and severity and extent of coronary artery disease (CAD).
B-mode ultrasound and quantitative coronary angiography (QCA) were used to assess carotid, and coronary artery atherosclerosis in 91 patients with clinically suspected CAD referred for cardiac catheterization. Two apoE phenotype groups were defined: apoE3 (E3/E3) and apoE4 (including E4/E3, E4/E4 phenotypes). Maximum IMT was higher in the apoE4 group than in the apoE3 group (p=0.022). The global atheroma burden index was similarly higher in the apoE4 group than in the apoE3 group (p=0.033). ApoE4 subjects had higher levels of apolipoprotein B (apoB) (p=0.008), triglycerides (p=0.006), remnant lipoprotein-cholesterol (RLP-C) (p=0.023), and lipoprotein(a) [(Lp(a)] (p=0.041) than apoE3 subjects. The mean LDL particle size was smaller in the apoE4 group than in the apoE3 group (p=0.041).
ApoE polymorphism was associated with both carotid and coronary atherosclerosis. Patients with the apoE4 isoform had an increased carotid IMT and a more severe and extensive CAD than patients with the apoE3 isoform.
载脂蛋白E（apoE）基因多态性在动脉粥样硬化和心血管疾病的发生发展中起重要作用。因此，本研究旨在探讨apoE基因多态性与颈动脉内膜中层厚度（IMT）以及冠状动脉疾病（CAD）的严重程度和范围之间的关联。
对91例临床怀疑患有CAD并接受心脏导管插入术的患者，采用B型超声和定量冠状动脉造影（QCA）评估颈动脉和冠状动脉粥样硬化情况。定义了两个apoE表型组：apoE3（E3/E3）和apoE4（包括E4/E3、E4/E4表型）。apoE4组的最大IMT高于apoE3组（p = 0.022）。apoE4组的整体动脉粥样硬化负荷指数同样高于apoE3组（p = 0.033）。与apoE3受试者相比，apoE4受试者的载脂蛋白B（apoB）水平更高（p = 0.008）、甘油三酯水平更高（p = 0.006）、残余脂蛋白胆固醇（RLP-C）水平更高（p = 0.023）以及脂蛋白(a)[Lp(a)]水平更高（p = 0.041）。apoE4组的平均低密度脂蛋白颗粒大小小于apoE3组（p = 0.041）。
apoE基因多态性与颈动脉和冠状动脉粥样硬化均相关。与apoE3异构体患者相比，apoE4异构体患者的颈动脉IMT增加，CAD更严重且范围更广。
