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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1996;16:918-925.)
© 1996 American Heart Association, Inc.

Articles

Apolipoprotein E Polymorphism in American Indians and Its Relation to Plasma Lipoproteins and Diabetes

The Strong Heart Study

Shinkuro Kataoka; David C. Robbins; Linda D. Cowan; Oscar Go; Jeunliang L. Yeh; Richard B. Devereux; Richard R. Fabsitz; Elisa T. Lee; Thomas K. Welty; Barbara V. Howard; for the Strong Heart Study Investigators

the Second Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan (S.K.); the Department of Biostatistics and Epidemiology, University of Oklahoma, Oklahoma City (L.D.C., E.T.L.); the Center for Epidemiologic Research, University of Oklahoma Health Sciences Center, Oklahoma City (J.L.Y., O.G.); Medlantic Research Institute, Washington, DC (D.C.R., B.V.H.); Cornell Medical Center, New York, NY (R.B.D.); the National Heart, Lung, and Blood Institute, Bethesda, Md (R.R.F.); and the Aberdeen Area Indian Health Service, Rapid City, SD (T.K.W.).

Correspondence to Dr Barbara V. Howard, Medlantic Research Institute, 108 Irving St, NW, Washington, DC 20010-2933.

Apo E is an important genetic factor in the development of cardiovascular disease, which is the leading cause of death among American Indians. We investigated the occurrence of the apo E alleles and the relation between apo E polymorphism and blood lipoproteins and apoproteins in members of 13 American Indian communities in three geographic areas. The frequencies of the 2 alleles in American Indians are significantly lower than those in white Americans, with the lowest frequencies of 2 in American Indians who reside in Arizona. Levels of LDL cholesterol and apo B were highest in those with 4 and lowest in those with 2. Concentrations of HDL cholesterol and apo A-I, however, tended to be lowest in 4 and highest in 2. Concentrations of total and VLDL triglycerides were lowest in the 3 group and higher in groups 2 and 4. Differences in concentrations of LDL cholesterol, HDL cholesterol, apo B, and apo A-I with apo E polymorphism were greater in women than in men, and differences in total and VLDL triglyceride concentrations by apo E phenotype were greater in men. Relations of total and VLDL triglycerides with apo E phenotype were stronger in women after menopause. In addition, differences in nearly all lipid and apoprotein concentrations between postmenopausal women and premenopausal women were greater if they had 2. Relations between apo E phenotype and lipoproteins were seen in individuals with diabetes mellitus as well as in nondiabetics. Apo E was significantly related to glucose control in diabetic women; those with 3 had higher glucose and hemoglobin A_1C concentrations. Our findings show that (1) American Indians have low frequencies of apo 2; (2) apo E phenotype can influence levels of VLDL, LDL, HDL, apo B, and apo A-I; (3) the associations of apo E polymorphisms with lipid parameters differ between men and women; and (4) the associations in women of apo E polymorphisms with lipid parameters are modified by menopausal status.

Key Words: lipoprotein • apolipoprotein E • diabetes • cholesterol • American Indians

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