普通人群中载脂蛋白E的血浆水平与缺血性心脏病风险

Plasma levels of apolipoprotein E and risk of ischemic heart disease in the general population.

作者信息

Rasmussen Katrine L, Tybjærg-Hansen Anne, Nordestgaard Børge G, Frikke-Schmidt Ruth

机构信息

Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark.

Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark; Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark.

出版信息

Atherosclerosis. 2016 Mar;246:63-70. doi: 10.1016/j.atherosclerosis.2015.12.038. Epub 2015 Dec 29.

DOI:10.1016/j.atherosclerosis.2015.12.038

PMID:26761769

Abstract

BACKGROUND AND AIMS

Triglyceride-rich lipoproteins are causally associated with high risk of ischemic heart disease (IHD), and apolipoprotein E (apoE) has a central role in their plasma clearance. While both quantitative and qualitative changes of apoE are established causes of rare dyslipidemia syndromes, it remains unclear whether plasma levels of apoE are associated with risk of IHD in the general population.

METHODS

We tested whether plasma levels of apoE at enrollment were associated with future risk of IHD and myocardial infarction (MI) in 91,695 individuals from the general population.

RESULTS

Multifactorially adjusted hazard ratios (HRs) for highest versus lowest apoE tertile were 1.15 (1.04-1.27) for IHD and 1.16 (1.00-1.36) for MI in men, and 0.94 (0.84-1.05) and 1.04 (0.85-1.26) in women. These associations were attenuated by adjustments for triglyceride levels. Corresponding HRs for highest versus lowest apoE tertile in ε33 carriers were 1.18 (1.03-1.36) for IHD and 1.21 (0.98-1.49) for MI in men, and 0.91 (0.78-1.06) and 0.93 (0.71-1.21) in women. Thus, the present associations were independent of APOE genotype.

CONCLUSION

These findings suggest that high plasma levels of apoE are associated with IHD in men but not in women. Triglyceride-rich lipoproteins may partly explain these associations.

摘要

背景与目的

富含甘油三酯的脂蛋白与缺血性心脏病（IHD）的高风险存在因果关联，载脂蛋白E（apoE）在其血浆清除过程中起核心作用。虽然apoE的定量和定性变化均是罕见血脂异常综合征的确切病因，但尚不清楚一般人群中apoE的血浆水平是否与IHD风险相关。

方法

我们对来自一般人群的91,695名个体进行了检测，以确定入组时apoE的血浆水平是否与未来IHD和心肌梗死（MI）风险相关。

结果

在多因素调整后，男性中apoE最高三分位数与最低三分位数相比，IHD的风险比（HR）为1.15（1.04 - 1.27），MI的风险比为1.16（1.00 - 1.36）；女性中分别为0.94（0.84 - 1.05）和1.04（0.85 - 1.26）。这些关联在调整甘油三酯水平后减弱。在ε33携带者中，男性apoE最高三分位数与最低三分位数相比，IHD的相应HR为1.18（1.03 - 1.36），MI的相应HR为1.21（0.98 - 1.49）；女性中分别为0.91（0.78 - 1.06）和0.93（0.71 - 1.21）。因此，目前的关联独立于APOE基因型。