Age-dependent association between hepatic lipase gene C-480T polymorphism and the risk of pre-hospital sudden cardiac death: the Helsinki Sudden Death Study

Genetic variations involved in sudden cardiac death and their associations and interactions

Although the mechanism of sudden cardiac death (SCD) in heart failure is not completely known, genetic variations are known to play key roles in this process. Increasing numbers of mutations and variants are being discovered through genome-wide association studies. The genetic variations involved in the mechanisms of SCD have aroused widespread concern. Comprehensive understanding of the genetic variations involved in SCD may help prevent it. To this end, we briefly reviewed the genetic variations involved in SCD and their associations and interactions, and observed that cardiac ion channels are the core molecules involved in this process. Genetic variations involved in cardiac structure, cardiogenesis and development, cell division and differentiation, and DNA replication and transcription are all speculated to be loci involved in SCD. Additionally, the systems involved in neurohumoral regulation as well as substance and energy metabolism are also potentially responsible for susceptibility to SCD. They form an elaborate network and mutually interact with each other to govern the fate of SCD-susceptible individuals.

Quantitative assessment of the effect of hepatic lipase gene polymorphism on the risk of coronary heart disease

BACKGROUND AND AIMS

The human hepatic lipase (LIPC) is a glycoprotein member of the lipase superfamily that has attracted considerable attention as a candidate gene for coronary heart disease (CHD) based on its enzyme function as a key factor in lipoprotein catabolism pathways. In the past decade, a number of case-control studies have been carried out to investigate the relationship between the LIPC polymorphisms and CHD. However, studies on the association between LIPC polymorphisms and CHD remain conflicting.

METHODS

To derive a more precise estimation of the relationship, a meta-analysis of 11,906 cases and 13,273 controls from 18 published case-control studies was performed.

RESULTS

Overall, the summary odds ratio of CHD was 0.87 (95% confidence interval: 0.66-1.15) and 1.03 (95% confidence interval: 0.98-1.07) for LIPC -250A and -514T alleles, respectively. No significant results were observed in heterozygous and homozygous when compared with wild genotype for these polymorphisms. In the stratified analyses according to ethnicity, source of controls, no evidence of any gene-disease association was obtained.

CONCLUSIONS

Our result suggest that the G-250A, C-514T polymorphisms of LIPC gene are not associated with CHD susceptibility.

LIPC variants in the promoter and intron 1 modify HDL-C levels in a sex-specific fashion

We previously reported linkage for plasma levels of high-density lipoprotein cholesterol (HDL-C) on 15q21 in Caucasian families from the National Heart, Lung, and Blood Institute Family Heart Study (NHLBI FHS). Hepatic lipase gene (LIPC), which has a major role in lipoprotein metabolism, resides within the linkage region and constitutes an obvious candidate gene. While hepatic lipase is a known player in HDL metabolism, the relationship between common LIPC variants and HDL-C levels remains unclear. In the current study, we employed population-based and family-based tests of association with both quantitative HDL-C levels and a dichotomous dyslipidemia trait (affected men: HDL<40 mg/dL and women: HDL<50 mg/dL, denoted as low HDL). We genotyped 19 tag-SNPs spanning 139.9 kb around the LIPC in the 591 families (2238 subjects). Strong association in a proxy-promoter 5' SNP (rs261342) and HDL-C levels was detected in women, but not in men. The less common allele was associated with an increase of approximately 14% in HDL-C levels, and a decrease of approximately 30% in risk of low HDL. In addition, strong association in women of an intron 1 SNP (rs12593008) and low HDL and moderate association in men (rs8028759) with both HDL-C levels and low HDL phenotype were found and may represent either functional single nucleotide polymorphisms (SNPs), or more likely, SNPs in linkage disequilibrium with functional variants. Because of the association of lipid abnormalities with diabetes, and other lifestyle parameters, we also performed association analyses using different covariate adjustments as well as strategically selected sub-samples. The sex-specific association of rs261342, rs12593008 or rs8028759 remained substantially the same through these analyses. Finally, we found that a common haplotype was overtransmitted to offspring with low HDL-C. The sex-specific associations found in our study could be due to the interactions with the endogenous hormonal environment, lifestyle and/or genetic factors, although the underlying physiologic mechanisms are not understood.

Age-dependent dichotomous effect of superoxide dismutase Ala16Val polymorphism on oxidized LDL levels

We investigated the association between superoxide dismutase (SOD) Ala16Val polymorphism and the levels of oxidized LDL lipoprotein-C (ox-LDL-C) in two age-different Greek cohorts. Four hundred fifteen middle-aged (n=147 females: 43.2+/-13 years, n=268 males: 43.3+/-14 years) Caucasian Greek subjects consisted the middle aged cohort. One hundred seventy five elderly (n=88 females: 79.9+/-4 years; n=87 males: 80.6+/-4 years) were selected from the elderly cohort. Genotype data were obtained for all of them. Multiple linear regression analysis, stratified by gender and adjusted for age, smoking habits and body mass index as covariates, showed higher ox-LDL-C levels for the middle aged men with the Val/Val genotype, compared to the other allele (Ala/Ala and Ala/Val) carriers (65.9+/-25.7 vs. 55.7+/-20.5 mg/dl; standardized beta coefficient=0.192, P=0.012). On the contrary, elderly women with the Val/Val genotype occurred with lower ox-LDL-C levels compared to the Ala/Ala or Ala/Val genotype (74.2+/-22.1 vs. 86.5+/-26.6 mg/dl; standardized beta coefficient= -0.269, P=0.015). The same trend was also recorded in elderly men, however without reaching statistical significance (standardized beta coefficient= -0.187, P=0.077). Moreover, elderly men and women with the Ala/Ala or Ala/Val genotype presented higher triglycerides levels compared to Val/Val (women: 145.2+/-68.7 vs. 114.3+/- 34.3 mg/dl, P= 0.027; men: 147.8+/-72.4 vs. 103.7 +/-38.0 mg/dl, P=0.002). Additionally, middle aged men with the Val/Val genotype had higher HDL-C levels compared to the Ala allele carriers. The results suggest that SOD Ala16Val polymorphism is an age-dependent modulator of ox-LDL-C levels in middle-aged men and elderly women.

The hepatic lipase gene C-480T polymorphism in the development of early coronary atherosclerosis: the Helsinki Sudden Death Study

BACKGROUND

The T allele of the hepatic lipase (HL) C-480T polymorphism was previously found to be associated with lower post-heparin plasma HL activity, atherosclerosis and risk of coronary artery disease. We studied the association of HL C-480T polymorphism with the extent of atherosclerosis at vessel-wall level in an autopsy series of middle-aged men.

MATERIALS AND METHODS

An autopsy cohort of 700 Caucasian Finnish men aged 33-70 years (mean 53 years), which comprised two autopsy series, collected 10 years apart during 1981-82 and 1991-92, were analysed. Areas of coronary wall covered with fatty streaks and fibrotic and complicated lesions were measured using computer-assisted planimetry and related to HL C-480T genotypes (CC, CT, and TT).

RESULTS

There was a significant age-by-genotype interaction on the mean percentage area of fatty streaks (P = 0.01). The HL C-480T polymorphism was a significant explanatory factor for fatty streak area in men under 53 years of age with or without age, body mass index, hypertension, diabetes, smoking, alcohol consumption, apolipoprotein E genotype, and series number as covariates. Men carrying the TT genotype had two times larger areas of fatty streaks compared to the CC carriers (8.8% vs. 4.3%, P = 0.009). However, this association disappeared in men over 53 years. The areas of more advanced atherosclerotic lesions did not vary significantly among the genotype groups.

CONCLUSIONS

Our results suggest that the HL C-480T polymorphism affects the formation of early coronary atherosclerotic lesions in men in their early middle age.