载脂蛋白 E 基因型、血脂谱、运动与心血管发病率和 18 年死亡率的关系。

ApoE Genotype, Lipid Profile, Exercise, and the Associations With Cardiovascular Morbidity and 18-Year Mortality.

机构信息

Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel.

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

J Gerontol A Biol Sci Med Sci. 2020 Sep 25;75(10):1887-1893. doi: 10.1093/gerona/glz232.

DOI:10.1093/gerona/glz232

PMID:31585002

Abstract

BACKGROUND

Studies of longevity examined apolipoprotein E (ApoE), a gene involved in lipoprotein metabolism, which interacts with susceptibility to age-related diseases, and with mortality. We evaluated the association of ApoE isoforms with cardiovascular disease (CVD) and all-cause mortality.

METHODS

A prospective cohort of 949 survivors of the Israel Study of Glucose Intolerance, Obesity, and Hypertension, examined during 1999-2004, mean age 72 years, was followed for mortality until 2017. Participants were interviewed for lifestyle habits and medical history. Anthropometrics and biochemical markers were taken. Logistic regression was used to assess CVD morbidity and Cox proportional hazard model for mortality.

RESULTS

The most common genotype in the cohort was ApoE E3 (76.3%), with the other two almost equally distributed (ApoE E2 11.2% and ApoE E4 12.5%). In men only, ApoE E4 associated with CVD (adjusted odds ratio = 1.46, 95% confidence interval [CI] 0.76, 2.80) and with 18-year mortality (adjusted hazard ratio = 1.47, 95% CI 0.95, 2.26), adjusting for age, ethnicity, physical activity, hypertension, diabetes, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides and lipid-lowering medications. Low levels of HDL cholesterol, adjusted for ApoE and the above-mentioned variables, associated with higher prevalence of CVD (adjusted odds ratio = 1.35, 95% CI 1.00, 1.83) and all-cause mortality (adjusted hazard ratio = 1.42, 95% CI 1.14, 1.78). ApoE E3 and E2 conferred a lower 18-year mortality risk in the physically active individuals, compared to the sedentary (adjusted hazard ratio = 0.57, 95% CI 0.44, 0.74, and adjusted hazard ratio = 0.53, 95% CI 0.78, 1.02, respectively).

CONCLUSIONS

In community-dwelling older adults, sociodemographic characteristics and physical activity, blood pressure and HDL-cholesterol levels, may outweigh the impact of ApoE polymorphisms on CVD morbidity and all-cause mortality.

摘要

背景

研究长寿的学者研究了载脂蛋白 E（ApoE），一种参与脂蛋白代谢的基因，它与与年龄相关疾病的易感性以及死亡率有关。我们评估了 ApoE 异构体与心血管疾病（CVD）和全因死亡率的关系。

方法

我们对 1999-2004 年期间接受检查的以色列葡萄糖耐量异常、肥胖和高血压研究的 949 名幸存者进行了前瞻性队列研究，平均年龄为 72 岁，随访至 2017 年以记录死亡率。研究对象接受了生活方式和病史的访谈。进行了人体测量和生化标志物检测。使用逻辑回归评估 CVD 发病率，使用 Cox 比例风险模型评估死亡率。

结果

在该队列中，最常见的基因型是 ApoE E3（76.3%），其他两种基因型的分布几乎相同（ApoE E2 为 11.2%，ApoE E4 为 12.5%）。仅在男性中，ApoE E4 与 CVD（调整后的优势比=1.46，95%置信区间[CI]0.76，2.80）和 18 年死亡率（调整后的危险比=1.47，95%CI0.95，2.26）相关，调整因素包括年龄、种族、体力活动、高血压、糖尿病、低密度脂蛋白（LDL）-胆固醇、高密度脂蛋白（HDL）-胆固醇、甘油三酯和降脂药物。经 ApoE 和上述变量调整后的低水平 HDL 胆固醇与 CVD 患病率较高相关（调整后的优势比=1.35，95%CI1.00，1.83）和全因死亡率（调整后的危险比=1.42，95%CI1.14，1.78）。与久坐不动的人相比，活跃的个体中 ApoE E3 和 E2 降低了 18 年的死亡率风险（调整后的危险比=0.57，95%CI0.44，0.74，和调整后的危险比=0.53，95%CI0.78，1.02）。