Abstract 15371: APOE Genotype Influences the Relation Between Adiposity and Plasma Lipid Levels in Patients With Vascular Disease: The SMART Study
Introduction: APOE genotype is suggested to play a role in the heterogeneity of plasma lipid levels. Whether and how APOE genotype influences the effect of adiposity on lipids is unclear. We evaluated the relation between adiposity measures and lipids according to APOE genotype in patients with manifest vascular disease.
Methods: This cross-sectional study was performed in 5512 patients with clinically manifest arterial disease from the Secondary Manifestations of ARTerial disease (SMART) study (59 ε2 homozygotes (ε2ε2), 670 ε2 heterozygotes (ε2h), 3214 ε3 homozygotes (ε3ε3) and 1569 ε4 carriers (ε4c)). Lipids of interest were non-HDL cholesterol (non-HDL-c), LDL cholesterol (LDL-c) and triglycerides (TG). Patient characteristics were age, sex, body mass index (BMI), waist circumference (waist), abdominal fat measured by ultrasound (abdominal fat), metabolic syndrome and diabetes mellitus (DM). Results from regression analyses are given as β-coefficient with 95% confidence interval after adjustment for age, sex and lipid lowering medication.
Results: The relation between adiposity measures and non-HDL-c according to APOE genotype is shown in table 1. There was significant effect modification of the ε2ε2 genotype on the relation between non-HDL-c and BMI (p=0.002), waist (p<0.001), abdominal fat (p<0.001) and metabolic syndrome (p<0.001). The ε2ε2 genotype also significantly modified the relation between LDL-c and female sex (p=0.004) and waist (p=0.019). For DM no significant interaction with ε2ε2 was found (p=0.456 and p=0.213 for non-HDL-c and LDL-c respectively).
Conclusion: APOE genotype influences the relation between adiposity (BMI, waist, abdominal fat and metabolic syndrome) and plasma lipid levels in patients with manifest vascular disease. The effect of adiposity on lipids is the largest in patients with the ε2ε2 genotype.
- © 2013 by American Heart Association, Inc.