Srinivasan S R, Ehnholm C, Wattigney W A, Bao W, Berenson G S
Tulane National Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112-2824, USA.
Atherosclerosis. 1996 Jun;123(1-2):33-42. doi: 10.1016/0021-9150(95)05762-5.
Apolipoprotein (apo) E is an important genetic determinant of serum lipoprotein concentrations and coronary artery disease risk. Multiple cardiovascular risk factors in addition to lipoproteins were examined by apoE phenotype in a random subsample (n = 746) of 8-17-year old children from a total community. The apoE2 group (n = 58) carrying E2/2 and E3/2 phenotypes showed lower age-, race- and sex-adjusted mean values of body mass index (BMI: weight/height2), percent body fat, fasting plasma insulin and LDL cholesterol, and a higher value of HDL cholesterol than the apoE3 group (n = 476) carrying the E3/3 phenotype (P < 0.01). In contrast, the apoE4 group (n = 212) carrying E4/4 and E3/4 phenotypes displayed higher values of total cholesterol and LDL cholesterol (P < 0.01). Both insulin and BMI, which correlated with each other, showed an association to triglycerides and systolic blood pressure in all three phenotype groups; whereas only BMI associated with LDL cholesterol, total cholesterol to HDL cholesterol ratio and diastolic blood pressure in all three phenotype groups (P < 0.05 to P < 0.0001). A marked increase in the prevalence of clustering of adverse (top tertile) total cholesterol to HDL cholesterol ratio with increased levels (top tertile) of one or two risk factors (BMI, insulin, and systolic blood pressure) occurred in the apoE3 and apoE4 groups, especially in the latter (P < 0.01 to P < 0.0001), but not in the apoE2 group. The prevalence of parental history of heart attack and diabetes mellitus among the three phenotype groups paralleled this trend. Thus, the risk status of apoE polymorphism may be associated with a constellation of cardiovascular risk factors in early life.
载脂蛋白（apo）E是血清脂蛋白浓度和冠状动脉疾病风险的重要遗传决定因素。在一个社区中随机抽取的8至17岁儿童子样本（n = 746）中，通过apoE表型研究了除脂蛋白外的多种心血管危险因素。携带E2/2和E3/2表型的apoE2组（n = 58），其年龄、种族和性别校正后的体重指数（BMI：体重/身高²）、体脂百分比、空腹血浆胰岛素和低密度脂蛋白胆固醇的平均值较低，高密度脂蛋白胆固醇的值高于携带E3/3表型的apoE3组（n = 476）（P < 0.01）。相比之下，携带E4/4和E3/4表型的apoE4组（n = 212）总胆固醇和低密度脂蛋白胆固醇的值较高（P < 0.01）。在所有三个表型组中，相互关联的胰岛素和BMI均与甘油三酯和收缩压相关；而在所有三个表型组中，只有BMI与低密度脂蛋白胆固醇、总胆固醇与高密度脂蛋白胆固醇的比值以及舒张压相关（P < 0.05至P < 0.0001）。在apoE3组和apoE4组中，尤其是后者，不良（最高三分位数）总胆固醇与高密度脂蛋白胆固醇比值的聚集患病率随着一个或两个危险因素（BMI、胰岛素和收缩压）水平的升高（最高三分位数）而显著增加（P < 0.01至P < 0.0001），但在apoE2组中未出现这种情况。三个表型组中心脏病发作和糖尿病家族史的患病率也呈现出类似趋势。因此，apoE多态性的风险状态可能与生命早期的一系列心血管危险因素相关。
