title: Effect of obesity, serum lipoproteins, and apolipoprotein E genotypes on mortality in hospitalized elderly patients.
abstract: BACKGROUND
  The aim of this study was to investigate the relationship among apolipoprotein E (APOE) polymorphism, body mass index (BMI), and dyslipidemia and how these factors modify overall mortality in a cohort of hospitalized elderly patients.
  
  
  METHODS
  Plasma concentrations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), BMI, and APOE genotype were evaluated in 1,012 hospitalized elderly patients, who were stratified into three groups according to their baseline BMI and APOE allele status. Multivariate logistic regression analysis was used to assess whether APOE genotype, BMI, and dyslipidemia are associated with mortality, adjusting for potential confounders. Interaction analysis was also performed.
  
  
  RESULTS
  Obese patients have significantly higher levels of TC and LDL-C compared to normal-weight and overweight subjects, for both sexes. APOE ε4 carriers have significantly higher levels of TC and LDL-C compared with ε2 and ε3 carrier both in males and females. Interaction analysis showed that women with TC < 180  mg/dL, LDL-C < 100  mg/dL, normal weight, and ε3 carrier (odds ratio [OR] = 3.42, 95% confidence interval [CI] 1.36-8.60) and men with LDL-C < 100  mg/dL, HDL-C < 40  mg/dL, and ε3 carrier (OR = 1.97, 95% CI 1.04-3.74) were at highest risk of mortality.
  
  
  CONCLUSIONS
  In elderly hospitalized patients, obesity and APOE genotype influence the lipid profile and mortality risk. A significant interaction among BMI, dyslipidemia, and APOE genotype was observed that could identify elderly patients with different risks of mortality.
authors: Geriatric Unit & Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors: Filomena
authors: F
authors: Addante
authors: Daniele
authors: D
authors: Sancarlo
authors: Massimiliano
authors: M
authors: Copetti
authors: Carlo
authors: C
authors: Scarcelli
authors: Maria Grazia
authors: MG
authors: Longo
authors: Valeria
authors: V
authors: Niro
authors: Giulia
authors: G
authors: Paroni
authors: Fabio
authors: F
authors: Pellegrini
authors: Luigi
authors: L
authors: Fontana
authors: Alberto
authors: A
authors: Pilotto
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