© 1997 American Heart Association, Inc.
Articles |
Association of Apo E Polymorphism With Plasma Lipid Levels in a Multiethnic Elderly Population
From the Division of General Medicine, College of Physicians & Surgeons (A.P.-M., S.S.); Division of Epidemiology, School of Public Health (A.P.-M., R.M., S.S.); Gertrude H. Sergievsky Center, College of Physicians & Surgeons (R.M.); and Division of Preventive Medicine, College of Physicians & Surgeons (L.B.), Columbia University, New York, NY.
Correspondence to Dr Lars Berglund, Division of Preventive Medicine and Nutrition, Department of Medicine, Columbia University, 630 W 168th St, P&S 9–510, New York, NY 10032-3702. E-mail berglun{at}cudept.cis.columbia
Abstract Apolipoprotein E polymorphisms are
important determinants of blood lipid levels and have been associated
with longevity and atherosclerosis. However,
information is limited on the effects of apo E variation on the lipids
of nonwhite and elderly individuals. We tested the hypothesis that apo
E polymorphisms are associated with plasma lipid levels in an
elderly, multiethnic population. Cross-sectional data from 1068
noninstitutionalized individuals from northern Manhattan over the age
of 64 who were not on a lipid-lowering diet or drug were
analyzed. The ethnic distribution was 34% African-Americans,
47% Hispanics, and 19% non-Hispanic Caucasians. In the entire group,
the most prevalent apo E allele was 
3 (76%), followed by 4
(16%) and 2 (8%); 4 was more prevalent in African-Americans
(21%) than in non-Hispanic Caucasians (12%) or Hispanics (14%). The
apo 2 allele was the most important correlate of plasma lipids,
but this association varied across ethnoracial groups. After being
adjusted for age, sex, obesity, diabetes mellitus, and alcohol intake,
LDL cholesterol levels declined with each apo 2
allele by 8.8 mg/dL in Hispanics and by 25.6 and 18.1 mg/dL in
non-Hispanic Caucasians and African-Americans, respectively
(P<.001). No significant independent effect was noted
for any apo E genotype on HDL cholesterol. Overall,
there was a reduction in the total/HDL cholesterol ratio,
per apo 2 allele, of 0.82 in non-Hispanic Caucasians and 0.43
and 0.48 in African-American and Hispanic individuals, respectively
(P<.05). In a multivariate model, apo
4 did not significantly affect plasma lipid levels. Plasma
triglyceride levels were inversely correlated with the
number of apo 4 alleles (175, 159, and 143 mg/dL with 0, 1, and
2 alleles, respectively; P =.002), and this effect
increased with age. Thus, in an elderly, multiethnic population,
apolipoprotein E polymorphisms were important determinants of blood
lipids, with differing effects depending on ethnicity. The presence of
apo 2 was associated with lower LDL cholesterol levels
and total/HDL cholesterol ratio, although apo
genotype did not influence HDL cholesterol levels.
Prospective studies are needed to test whether apo 2 protects
against incident cardiovascular disease in the
elderly.
Key Words: epidemiology • genetics • apo E • serum lipids • elderly
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