Associations of apolipoprotein E exon 4 and lipoprotein lipase S447X polymorphisms with acute ischemic stroke and myocardial infarction.
BACKGROUND
Because apolipoprotein E (apoE) and lipopoprotein lipase (LPL) polymorphisms interact with each other and with other factors to affect lipid metabolism, we sought to determine their separate and combined effects in association with ischemic vascular disease.


METHODS
We performed a case-control study of 816 subjects: 246 acute ischemic stroke patients, 234 acute myocardial infarction patients, and 336 controls. APOE exon 4 and LPL S447X genotypes were determined.


RESULTS
APOE epsilon2 and epsilon4 homozygotes were increased in stroke (4.5% vs. 1.0%, p = 0.008), while in myocardial infarction the epsilon4 allele was increased (12.6% vs. 9.5%, p = 0.006) but epsilon2 was decreased (3.7% vs. 12.1%, p = 0.000006). For subjects with either APOE epsilon2 or epsilon4 alleles, LPL X alleles were increased in vascular disease (OR = 2.2, p = 0.01). LPL X alleles displayed opposite tendencies toward association with disease when subjects were divided by sex, smoking, or APOE genotype. Meta-analysis and regression analysis of previous studies supported the sex and smoking dichotomies.


CONCLUSIONS
This is the first report of an association of vascular disease with an interaction of APOE exon 4 and LPL S447X genotypes. Therefore, APOE genotypes and LPL S447X interactions with apoE, sex, and smoking may affect the risk of myocardial infarction and ischemic stroke.
Baum
Larry
L
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong. lwbaum@cuhk.edu.hk
Ng
Ho Keung
HK
Wong
Ka Sing
KS
Tomlinson
Brian
B
Rainer
Timothy Hudson
TH
Chen
Xiangyan
X
Cheung
Wing Sze
WS
Tang
Jinling
J
Tam
Wilson Wai San
WW
Goggins
William
W
Tong
Cindy See Wai
CS
Chan
Daniel Kam Yin
DK
Thomas
G Neil
GN
Chook
Ping
P
Woo
Kam Sang
KS
D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D005091:Exons / Q000235:genetics*; D005260:Female; D005838:Genotype; D006723:Hong Kong; D006801:Humans; D008071:Lipoprotein Lipase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000235:genetics*; D011110:Polymorphism, Genetic; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000453:epidemiology / Q000235:genetics*
D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D008071:Lipoprotein Lipase