Apolipoprotein E4 allele influences the response of plasma triglyceride levels to tamoxifen in breast cancer patients.
BACKGROUND
Apolipoprotein E4 (APOE4) allele is an important risk factor for breast cancer and affects clearance of chylomicron remnants. Tamoxifen therapy increases serum triglyceride levels and sometimes inducing severe hypertriglyceridemia in breast cancer patients.


METHODS
Thirty-three women with breast cancer were recruited to examine the APOE polymorphism and fasting plasma lipid profiles before and after tamoxifen treatment for 6 months.


RESULTS
We found that plasma lipid profiles changed in accordance with the APOE4 allele after tamoxifen treatment for 6 months. Especially plasma triglyceride levels significantly decreased in the APOE4-positive patients (p=0.025), while there was no change in APOE4-negative patients (p=0.189). The total plasma cholesterol levels were reduced in APOE-4 positive patients after 6-month tamoxifen treatment (p=0.014). The levels of plasma low density lipoprotein cholesterol and high density lipoprotein cholesterol significantly decreased in both APOE4-negative and APOE4-positive patients.


CONCLUSIONS
These findings indicate that the effects of tamoxifen on plasma triglyceride levels are modified by APOE polymorphism. Breast cancer patients with APOE4 allele have low plasma triglyceride levels when receiving tamoxifen therapy. Therefore, we suggest that APOE gene polymorphism is a critical validation before tamoxifen treatment in breast cancer patients.
Chang
Nai-Wen
NW
Department of Biochemistry, College of Medicine, China Medical University, Taiwan, ROC. nwchang@mail.cmu.edu.tw
Chen
Fei-Na
FN
Wu
Chen-Teng
CT
Lin
Chin-Fen
CF
Chen
Dar-Ren
DR
D000328:Adult; D000368:Aged; D000483:Alleles; D053327:Apolipoprotein E4 / Q000235:genetics*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000235:genetics*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D011110:Polymorphism, Genetic; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood*
D053327:Apolipoprotein E4; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D013629:Tamoxifen