Apolipoprotein E phenotypes in hemodialysis patients.
BACKGROUND
Apolipoprotein (apo) E polymorphism consists of three major isoproteins (E2, E3, and E4). Because of their difference in a lipid-modulating effect, the polymorphism has been reported to affect the morbidity of atherosclerosis in general population. Therefore, in hemodialysis (HD) patients, the apo E polymorphism may also modulate serum levels of cholesterol and susceptibility to atherosclerotic vascular disease.


METHODS
We determined apo E phenotypes in 493 HD patients and 422 controls. We also investigated vascular risk profile and measured postprandial serum levels of lipids and apos in the dialysis patients.


RESULTS
We found a similar phenotype distribution and allele frequency between HD patients and healthy controls. Serum levels of total cholesterol, triglyceride, and apo A I, A II, and C III did not differ significantly among patients with phenotypes apo E2/3, E3/3, and E3/4. Patients with apo E3/4 had significantly lower levels of high-density lipoprotein cholesterol, significantly higher levels of low-density lipoprotein cholesterol (LDL-C), and a higher atherogenic index than those with apo E2/3 (LDL-C, 100 +/- 30 vs. 82 +/- 35 mg/dl, P < 0.01; the index, 3.3 +/- 1.7 vs. 2.3 +/- 1.3, P < 0.01). Patients with apo E3/4 showed a tendency toward higher levels of apo B than patients with apo E2/3 or apo E3/3. Multiple logistic regression analysis revealed that age and diabetes mellitus, but not apo E phenotypes, were independent risk factors for vascular disease.


CONCLUSIONS
Apo E polymorphism modulates cholesterol metabolism in dialysis patients but appears to have little association with the prevalence of atherosclerotic complications in the patients.
Department of Clinical and Laboratory Medicine, Faculty of Medicine, Fukui Medical University, Japan.
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T
Imura
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H
Kimura
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F
Gejyo
D000367:Age Factors; D000368:Aged; D000483:Alleles; D001057:Apolipoproteins E / Q000235:genetics*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D048909:Diabetes Complications; D005260:Female; D005787:Gene Frequency; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D014652:Vascular Diseases / Q000097:blood / Q000150:complications
D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL