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High Serum Apolipoprotein E Determines Hypertriglyceridemic Dyslipidemias, Coronary Disease and ApoA-I Dysfunctionality

  • Original Article
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Lipids

Abstract

The relevance of serum apolipoprotein E (apoE) levels to two hypertriglyceridemic dyslipidemias has not been clarified. We explored, in a cross-sectional (and short-term prospective) evaluation, the independent relationship of serum apoE to the atherogenic dyslipidemia, hypertriglyceridemia with elevated apoB (HtgB) and to apoA-I dysfunctionality, previously shown in Turkish adults to be independent of apoE genotype. Serum apoE concentrations were measured by immunonephelometry in 1,127 middle-aged adults. In multivariable regression analysis, apoE concentrations showed log-linear associations with apoB and apoA-I levels, waist circumference, independent of C-reactive protein (CRP), homeostatic model assessment (HOMA) index and other confounders. The likelihood of atherogenic dyslipidemia and of HtgB roughly tripled per 1-SD increment in apoE concentrations, additively to apoE genotype, HOMA, apoA-I, CRP concentrations and waist circumference; yet apoA-I, protective against atherogenic dyslipidemia, appeared to promote HtgB, a finding consistent with apoA-I dysfunctionality in this setting. Each 1-SD increment in the apoE level was moreover, associated in both genders with MetS (at OR 1.5), after adjustment for sex, age, apoB, apoA-I and CRP, or for apoE genotypes. Circulating apoE predicted in both genders age-adjusted prevalent and incident coronary heart disease (CHD), independent of apoE genotype and CRP (OR 1.32 [95 % CI 1.11; 1.58]). To conclude, in a general population prone to MetS, elevated apoE concentrations are strongly linked to HtgB and atherogenic dyslipidemia, irrespective of apoE genotype, are associated with MetS and CHD. Excess apoE reflects pro-inflammatory state and likely autoimmune activation.

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Abbreviations

apo:

Apolipoprotein

LDL:

Low-density lipoprotein

CHD:

Coronary heart disease

Lp(a):

Lipoprotein(a)

CRP:

C-reactive protein

MetS:

Metabolic syndrome

HDL:

High-density lipoprotein

SHBG:

Sex hormone-binding globulin

HOMA:

Homeostatic model assessment

TARF:

Turkish adult risk factor study

HtgB:

Hypertriglyceridemia with elevated apoB

VLDL:

Very low-density lipoprotein

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Acknowledgments

We thank the Turkish Society of Cardiology and the pharmaceutical companies AstraZeneca and Servier, İstanbul, which have financially supported the Turkish Adult Risk Factor surveys and thank the Turkish Ministry of Health for logistic support. We appreciate the input of G. Hergenç, Ph.D., in biochemical analyses and the dedicated works of G. Çiçek, MD, and Mr. M. Özmay in the survey teams.

Conflict of interest

No conflict of interest is declared by any author.

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Authors and Affiliations

  1. Turkish Society of Cardiology, Nisbetiye cad. 59/24, Istanbul, Etiler, 34335, Turkey

    Altan Onat

  2. Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey

    Altan Onat & Günay Can

  3. Etlik Ihtisas Education Hospital, Ankara, Etlik, Turkey

    Ender Örnek & Sani N. Murat

  4. Cardiology Department, Medical Faculty, Balıkesir University, Balıkesir, Turkey

    Erkan Ayhan

  5. Department of Genetics, Institute for Experimental Medical, Istanbul University, Istanbul, Turkey

    Nihan Erginel-Ünaltuna

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  1. Altan Onat
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  2. Günay Can
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  3. Ender Örnek
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  4. Erkan Ayhan
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  6. Sani N. Murat
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Correspondence to Altan Onat.

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Onat, A., Can, G., Örnek, E. et al. High Serum Apolipoprotein E Determines Hypertriglyceridemic Dyslipidemias, Coronary Disease and ApoA-I Dysfunctionality. Lipids 48, 51–61 (2013). https://doi.org/10.1007/s11745-012-3724-8

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  • DOI: https://doi.org/10.1007/s11745-012-3724-8

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