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Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:468-478

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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:468-478.)
© 1995 American Heart Association, Inc.


Articles

A Common Variant in the Gene for Lipoprotein Lipase (Asp9->Asn)

Functional Implications and Prevalence in Normal and Hyperlipidemic Subjects

France Mailly; Yesim Tugrul; Paul W. A. Reymer; Taco Bruin; Mary Seed; Björn F. Groenemeyer; Anette Asplund-Carlson; David Vallance; Anthony F. Winder; George J. Miller; John J. P. Kastelein; Anders Hamsten; Gunilla Olivecrona; Steve E. Humphries; Philippa J. Talmud

From the Division of Cardiovascular Genetics, Department of Medicine, UCL Medical School, Rayne Institute, London, UK (F.M., S.E.H., P.J.T.); the Department of Medical Biochemistry and Biophysics, University of Umea, Umea, Sweden (Y.T., G.O.); the Lipid Research Group, Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (P.W.A.R., T.B., B.F.G., J.J.P.K.); the Department of Medicine, Charing Cross Hospital, London, UK (M.S.); the Atherosclerosis Research Unit, King Gustaf V Research Institute, Stockholm, Sweden (A.A.-C., A.H.); the Department of Chemical Pathology and Human Metabolism, Royal Free Hospital School of Medicine, London, UK (D.V., A.F.W.); and the MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, The Medical College of St Bart's Hospital, London, UK (G.J.M.).

Correspondence to Dr Philippa Talmud, Department of Medicine, Division of Cardiovascular Genetics, University College London Medical School, The Rayne Institute, University St, London, WC1E 6JJ England.

Abstract Subjects with combined hyperlipidemia (CHL) were screened for mutations in the lipoprotein lipase (LPL) gene by single-strand conformational polymorphism, and a previously reported G->A DNA sequence change in exon 2, causing substitution of Asp by Asn at position 9, was identified in 2 individuals. Because this substitution destroys a recognition site for Taq I, pooling of DNA samples, amplification, and digest with Taq I allowed the rapid screening of 1563 healthy individuals and patients of Dutch, Swedish, English, and Scottish origin. In the general populations of all four countries, healthy carriers of the mutation were detected at a frequency of 1.6% to 4.4% (mean, 3.0%; 95% confidence interval, 2.0% to 4.0%). The frequency of carriers was roughly twice as high (range, 4.0% to 9.8%) in selected patients with CHL or type IV hyperlipoproteinemia or in subjects with angiographically assessed atherosclerosis; the frequency was consistently higher in each patient group compared with its matched control group. In 773 healthy men from two general practices in the United Kingdom, 25 carriers and 2 homozygotes for the mutation were identified. In these 27, plasma triglyceride but not plasma cholesterol levels were significantly higher than in noncarriers (2.25 versus 1.82 mmol/L, P<.02), and this difference was maintained in three subsequent annual measurements. Postheparin LPL activity data were available for some carriers and for 7 of 9 individuals from the patient groups, and 6 of 6 individuals from the control groups had LPL activity that was lower than the respective group mean. In vitro mutagenesis and transient expression in COS cells showed that compared with the LPL-Asp9 construct, LPL-Asn9 activity and mass were reduced by 20% to 30% in the culture media. Overall however, LPL-Asn9 had only slightly reduced specific activity (by 18%). Thus, although the precise mechanism of the effect is unclear, the data strongly suggest that the LPL-Asn9 variant is associated with and may play a direct role in predisposing carriers to develop hypertriglyceridemia.


Key Words: familial combined hyperlipidemia • genetic predisposition • lipoprotein lipase




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