High Serum Apolipoprotein E Determines Hypertriglyceridemic Dyslipidemias, Coronary Disease and ApoA-I Dysfunctionality


ONAT A., Can G., ORNEK E., Ayhan E., Erginel-Unaltuna N., MURAT S. N.

LIPIDS, vol.48, no.1, pp.51-61, 2013 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 48 Issue: 1
  • Publication Date: 2013
  • Doi Number: 10.1007/s11745-012-3724-8
  • Journal Name: LIPIDS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.51-61
  • Keywords: Apolipoprotein A-I, Apolipoprotein B, Apolipoprotein E concentrations, Atherogenic dyslipidemia, Coronary heart disease, Hypertriglyceridemia with elevated apoB, HIGH-DENSITY-LIPOPROTEIN, METABOLIC SYNDROME, TRANSFER PROTEIN, ARTERY-DISEASE, A-I, RISK, CHOLESTEROL, HDL, INFLAMMATION, ASSOCIATION
  • Istanbul University Affiliated: Yes

Abstract

The relevance of serum apolipoprotein E (apoE) levels to two hypertriglyceridemic dyslipidemias has not been clarified. We explored, in a cross-sectional (and short-term prospective) evaluation, the independent relationship of serum apoE to the atherogenic dyslipidemia, hypertriglyceridemia with elevated apoB (HtgB) and to apoA-I dysfunctionality, previously shown in Turkish adults to be independent of apoE genotype. Serum apoE concentrations were measured by immunonephelometry in 1,127 middle-aged adults. In multivariable regression analysis, apoE concentrations showed log-linear associations with apoB and apoA-I levels, waist circumference, independent of C-reactive protein (CRP), homeostatic model assessment (HOMA) index and other confounders. The likelihood of atherogenic dyslipidemia and of HtgB roughly tripled per 1-SD increment in apoE concentrations, additively to apoE genotype, HOMA, apoA-I, CRP concentrations and waist circumference; yet apoA-I, protective against atherogenic dyslipidemia, appeared to promote HtgB, a finding consistent with apoA-I dysfunctionality in this setting. Each 1-SD increment in the apoE level was moreover, associated in both genders with MetS (at OR 1.5), after adjustment for sex, age, apoB, apoA-I and CRP, or for apoE genotypes. Circulating apoE predicted in both genders age-adjusted prevalent and incident coronary heart disease (CHD), independent of apoE genotype and CRP (OR 1.32 [95 % CI 1.11; 1.58]). To conclude, in a general population prone to MetS, elevated apoE concentrations are strongly linked to HtgB and atherogenic dyslipidemia, irrespective of apoE genotype, are associated with MetS and CHD. Excess apoE reflects pro-inflammatory state and likely autoimmune activation.