title: Interaction of apolipoprotein E gene polymorphisms on miscarriage risk in black and white American women.
abstract: OBJECTIVE
  To evaluate whether [1] apolipoprotein E (APOE) polymorphisms can differentially regulate miscarriage risk and [2] whether this genotype effect could also be modulated by the race within populations.
  
  
  METHODS
  Data were derived from the Coronary Artery Risk Development in Young Adults (CARDIA), a longitudinal study with black and white participants from four U.S.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Women without miscarriages (controls) and women who miscarried at least once (cases).
  
  
  METHODS
  None.
  
  
  METHODS
  A group of women (n = 1,372) successfully followed for 25 years and with their APOE alleles identified were analyzed for miscarriage risk throughout their reproductive life. Additionally, a larger longitudinal analysis encompassing all the participants who had their APOE characterized (n = 2,140) was also performed for the association between APOE and miscarriage risk.
  
  
  RESULTS
  In white women followed up for 25 years, the odds ratio for miscarriage associated with APOE*2 allele presence was 1.61 (95% confidence interval, 1.04-2.50) compared with APOE*33 carriers. This was a race-dependent phenomenon as no associations between APOE alleles and miscarriage was observed in black women. Likewise, Cox regression analysis showed that cumulative miscarriage risk in white women was 37.2% in the APOE*2 carriers compared with 27.8% and 24.8% in APOE*33 and APOE*4 carriers, respectively. With APOE*33 as the reference, the age-adjusted hazard ratio associated with carrying the APOE*2 allele was 1.47 (95 confidence interval, 1.06-2.05).
  
  
  CONCLUSIONS
  This variable miscarriage risk, produced by an interaction between genotype and race, may reconcile, at least partially, the conflicting reports of the association of APOE and miscarriage risk.
authors.affiliation: Adipocyte and Fat Biology Laboratory, Unidad de Investigación Traslacional, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gamundi-Segura
authors.affiliation: Adipocyte and Fat Biology Laboratory, Unidad de Investigación Traslacional, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Torres-Perez
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital Universitario Miguel Servet, Zaragoza, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Sanz-Paris
authors.affiliation: Adipocyte and Fat Biology Laboratory, Unidad de Investigación Traslacional, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud, Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain; Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Salud Carlos III, Madrid, Spain. Electronic address: jmarbones.iacs@aragon.es.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Arbones-Mainar
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D000328:Adult; D053329:Apolipoprotein E2 / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000235:genetics*; D044383:Black People / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D011247:Pregnancy; D012307:Risk Factors; D014481:United States; D044465:White People / Q000235:genetics*; D001741:Black or African American
chemical_list: D053329:Apolipoprotein E2; D053327:Apolipoprotein E4
keywords: APOE2; Apolipoprotein E; miscarriage; race; spontaneous pregnancy loss