title: A case-control study on the effects of the apolipoprotein E genotypes in nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease (NAFLD) has reached epidemic proportions being the most common cause of chronic liver disease in Western countries. The Apolipoprotein E (ApoE) gene has three major isoforms encoded by the ε2, ε3, and ε4 alleles, with the ε4 allele associated with hypercholesterolemia and the ε2 allele with the opposite effect. The role of apoE genotypes on NAFLD has been previously investigated with conflicting results. Our hospital-based case-control study conducted in Italy aims to explore the effect of the apoE genotypes on NAFLD risk and their effect on the clinical features of NAFLD patients. 310 NAFLD cases and 422 controls were genotyped for apoE. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) from logistic regression were used to explore the relationship between NAFLD and apoE genotypes, as well as their interaction with selected demographic and lifestyle factors. ApoE ε4 allele carriers showed a statistically significant two-fold reduction of NAFLD risk (OR = 0.51, 95% CI: 0.28-0.93) compared with ε3 homozygotes. A statistically significant lower HDL cholesterol level was observed for ApoE ε4 carriers if compared with ε3/ε3 genotype or ApoE ε2 carriers with a nearly linear decreasing trend from ApoE ε2 to ApoE ε4 carriers. Our study reports for the first time a protective effect of the ε4 allele towards NAFLD that might be attributable to its role in the regulation of hepatic triglycerides rich very low-density lipoproteins secretion.
authors.affiliation: Institute of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy. emmadefeo@yahoo.it
authors.forename: Emma
authors.initials: E
authors.lastname: De Feo
authors.forename: Consuelo
authors.initials: C
authors.lastname: Cefalo
authors.forename: Dario
authors.initials: D
authors.lastname: Arzani
authors.forename: Rosarita
authors.initials: R
authors.lastname: Amore
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
authors.forename: Antonio
authors.initials: A
authors.lastname: Grieco
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.forename: Luca
authors.initials: L
authors.lastname: Miele
authors.forename: Stefania
authors.initials: S
authors.lastname: Boccia
mesh_terms: D000328:Adult; D053327:Apolipoprotein E4 / Q000235:genetics*; D001057:Apolipoproteins E / Q000235:genetics*; D016022:Case-Control Studies; D005234:Fatty Liver / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E