Suwalak Tanida, Srisawasdi Pornpen, Puangpetch Apichaya, Santon Siwalee, Koomdee Napatrupron, Chamnanphon Montri, Charoenyingwattana Angkana, Chantratita Wasun, Sukasem Chonlaphat
Division of Pharmacogenomics and Personalized Medicine; Division of Clinical Chemistry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University.
Jpn J Infect Dis. 2015;68(1):5-12. doi: 10.7883/yoken.JJID.2013.190. Epub 2014 Nov 25.
The purpose of this retrospective case-control study was to investigate the frequency of Apolipoprotein E (ApoE) polymorphisms and their influence on antiretroviral therapy (ART)-induced lipodystrophy or dyslipidemia in HIV-infected Thai patients. The clinical characteristics and frequencies of ApoE genotypes were compared between the case (moderate to severe lipodystrophy, n = 67) and control (absent to mild lipodystrophy, n = 18) groups. The ApoE genotype frequencies among the 85 participants were 2.35% (n = 2) for E2/E2, 20% (n = 17) for E2/E3, 9.41% (n = 8) for E2/E4, 36.47% (n = 31) for E3/E3, 30.59% (n = 26) for E3/E4, and 1.18% (n = 1) for E4/E4. None of the ApoE genotypes showed association with ART-induced lipodystrophy. However, the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-cholesterol), and ApoB were lower in patients carrying the E2 allele but higher in E4 carriers. Interestingly, the ratios between TC and high-density lipoprotein (TC/HDL cholesterol ratio) and ApoB/ApoA-I ratio were significantly higher in the case group. Patients carrying the E2 allele displayed protective lipid profile, while those carrying E4 appeared to be at higher risk of dyslipidemia. In conclusion, ApoE polymorphisms were not associated with lipodystrophy in patients undergoing antiretroviral therapy but influenced lipid alteration.
这项回顾性病例对照研究的目的是调查载脂蛋白E(ApoE)基因多态性的频率及其对泰国HIV感染患者抗逆转录病毒疗法(ART)引起的脂肪代谢障碍或血脂异常的影响。比较了病例组(中度至重度脂肪代谢障碍,n = 67)和对照组(无至轻度脂肪代谢障碍,n = 18)的临床特征和ApoE基因型频率。85名参与者中,E2/E2的ApoE基因型频率为2.35%(n = 2),E2/E3为20%(n = 17),E2/E4为9.41%(n = 8),E3/E3为36.47%(n = 31),E3/E4为30.59%(n = 26),E4/E4为1.18%(n = 1)。没有一种ApoE基因型与ART引起的脂肪代谢障碍相关。然而,携带E2等位基因的患者总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-胆固醇)和载脂蛋白B水平较低,而携带E4的患者则较高。有趣的是,病例组中TC与高密度脂蛋白的比值(TC/HDL胆固醇比值)和载脂蛋白B/载脂蛋白A-I比值显著更高。携带E2等位基因的患者表现出保护性脂质谱,而携带E4的患者似乎血脂异常风险更高。总之,ApoE基因多态性与接受抗逆转录病毒治疗的患者的脂肪代谢障碍无关,但会影响脂质改变。