Apolipoprotein E phenotype, arterial disease, and mortality among older women: the study of osteoporotic fractures.
This study is an investigation of the relationship between apolipoprotein E (apoE) phenotype, arterial disease, and mortality in a group of women (n = 1,751) aged 65 years and older enrolled in the Study of Osteoporotic Fractures. Crude mortality rates were highest among women with the 4-3 and 4-4 phenotypes but age-adjusted mortality showed no statistically significant variations across the phenotype groups. Using multivariate analysis, the mortality experience of women with 4-3 or 4-4 apoE phenotypes was compared to that of women with the 3-3 phenotype: no significant excess total mortality was found [relative risk (RR) = 1.2, 95% confidence interval (CI) 0.8, 1.8] among women with the epsilon 4 allele. Similarly, neither cardiovascular (RR = 0.9. 95% CI 0.5, 1.8) nor cancer (RR = 1.5, 95% CI 0.8, 2.8) mortality rates were significantly different in this group of women. Inclusion of cholesterol levels in the regression models did not change the relative mortality risks. Among women 65-69 year of age epsilon 4 was associated with an approximate doubling of RR for death due to both cardiovascular disease and cancer. No association was found between apoE phenotype and the presence of lower extremity arterial disease (defined as an ankle/arm index of 0.9 or less). These results suggest that women with the epsilon 4 who survive to age 70 years or beyond have a life expectancy that is similar to that for women homozygous for the 3 allele who comprise the majority of the population.
Vogt
M T
MT
Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, Pennsylvania, USA.
Cauley
J A
JA
Kuller
L H
LH
D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D006801:Humans; D007866:Leg / Q000098:blood supply; D009369:Neoplasms / Q000401:mortality; D015663:Osteoporosis, Postmenopausal / Q000235:genetics* / Q000401:mortality; D010641:Phenotype; D011446:Prospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000235:genetics* / Q000401:mortality
D001057:Apolipoproteins E