, Volume 48, Issue 1, pp 51–61

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

  • Altan Onat
  • Günay Can
  • Ender Örnek
  • Erkan Ayhan
  • Nihan Erginel-Ünaltuna
  • Sani N. Murat
Original Article

DOI: 10.1007/s11745-012-3724-8

Cite this article as:
Onat, A., Can, G., Örnek, E. et al. Lipids (2013) 48: 51. doi:10.1007/s11745-012-3724-8


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.


Apolipoprotein A-IApolipoprotein BApolipoprotein E concentrationsAtherogenic dyslipidemiaCoronary heart diseaseHypertriglyceridemia with elevated apoB





Low-density lipoprotein


Coronary heart disease




C-reactive protein


Metabolic syndrome


High-density lipoprotein


Sex hormone-binding globulin


Homeostatic model assessment


Turkish adult risk factor study


Hypertriglyceridemia with elevated apoB


Very low-density lipoprotein

Copyright information

© AOCS 2012

Authors and Affiliations

  • Altan Onat
    • 1
    • 2
  • Günay Can
    • 2
  • Ender Örnek
    • 3
  • Erkan Ayhan
    • 4
  • Nihan Erginel-Ünaltuna
    • 5
  • Sani N. Murat
    • 3
  1. 1.Turkish Society of CardiologyIstanbulTurkey
  2. 2.Cerrahpaşa Medical FacultyIstanbul UniversityIstanbulTurkey
  3. 3.Etlik Ihtisas Education HospitalAnkaraTurkey
  4. 4.Cardiology Department, Medical FacultyBalıkesir UniversityBalıkesirTurkey
  5. 5.Department of Genetics, Institute for Experimental MedicalIstanbul UniversityIstanbulTurkey