title: Apolipoprotein E gene polymorphisms in patients with premature myocardial infarction: a case-controlled study in Asian Indians in North India.
abstract: OBJECTIVE
  Several factors, including abdominal obesity, insulin resistance, diabetes mellitus and low levels of high-density lipoprotein cholesterol have been implicated in the high prevalence and early onset of coronary heart disease in Asian Indians. However, there are no reports regarding the role of apolipoprotein E (apo E) gene polymorphisms in premature myocardial infarction (MI) in this population. This study aimed to study the role of apo E gene polymorphisms in premature MI patients and their relation to serum lipid levels.
  
  
  METHODS
  Apo E gene polymorphisms were analysed in 35 patients with MI aged <40 years and in 45 age- and sex-matched controls using polymerase chain reaction-restriction fragment length polymorphism. Levels of serum lipids were measured in addition to the evaluation of conventional risk factors.
  
  
  RESULTS
  Higher frequencies of the apo E4 allele (P<0.0001) and of genotypes E3/E4 (P<0.005) and E4/E4 (P<0.005) were recorded in the premature MI group compared with the controls. Multivariate regression analysis revealed that, after adjusting for other covariates, individuals with the E4 allele were at ~46 times higher odds to develop premature MI compared with individuals without the E4 allele [adjusted odds ratio, OR (95% confidence interval, CI): 45.7 (4.9-421.3)]. Among conventional risk factors, higher risk was observed in those having dyslipidaemia [OR (95% CI): 8.7 (0.9-86.6)] and those with a high waist : hip ratio [OR (95% CI): 5.6 (1.4-21.2)].
  
  
  CONCLUSIONS
  Based on the robust association, the apo E4 allele should be considered as an independent risk factor for premature MI in Asian Indians.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, New Delhi-110 029, India.
authors.forename: Prabhat
authors.initials: P
authors.lastname: Kumar
authors.forename: Kalpana
authors.initials: K
authors.lastname: Luthra
authors.forename: Manjari
authors.initials: M
authors.lastname: Dwivedi
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Behl
authors.forename: Ravinder M
authors.initials: RM
authors.lastname: Pandey
authors.forename: Anoop
authors.initials: A
authors.lastname: Misra
mesh_terms: D000328:Adult; D001057:Apolipoproteins E / Q000235:genetics*; D044466:Asian People / Q000235:genetics*; D001483:Base Sequence; D016022:Case-Control Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009203:Myocardial Infarction / Q000235:genetics*; D011110:Polymorphism, Genetic; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D001057:Apolipoproteins E