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Civeira F, Martín C, Cenarro A. APOE and familial hypercholesterolemia. Curr Opin Lipidol 2024; 35:195-199. [PMID: 38640077 DOI: 10.1097/mol.0000000000000937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
PURPOSE OF REVIEW Autosomal dominant hypercholesterolemia is a common cause of cardiovascular disease. In addition to the classic genes that cause hypercholesterolemia, LDLR, APOB and PCSK9 , a new locus has emerged as a candidate to be the cause of this hyperlipidemia, the p.(Leu167del) mutation in the APOE gene. RECENT FINDINGS Various studies have demonstrated the involvement of the p.(Leu167del) mutation in the APOE gene in hypercholesterolemia: Studies of family segregation, lipoprotein composition by ultracentrifugation and proteomic techniques, and functional studies of VLDL-carrying p.(Leu167del) internalization with cell cultures have demonstrated the role of this mutation in the cause of hypercholesterolemia. The phenotype of individuals carrying the p.(Leu167del) in APOE is indistinguishable from familial hypercholesterolemia individuals with mutations in the classic genes. However, a better response to lipid-lowering treatment has been demonstrated in these APOE mutation carrier individuals. SUMMARY Therefore, APOE gene should be considered a candidate locus along with LDLR, APOB , and PCSK9 to be investigated in the genetic diagnosis of familial hypercholesterolemia.
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Affiliation(s)
- Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV
- Universidad de Zaragoza, Zaragoza
| | - César Martín
- Biofisika Institute (UPV/EHU, CSIC), University of the Basque Country, Leioa
- Department of Biochemistry and Molecular Biology, UPV/EHU, University of the Basque Country, Bilbao
| | - Ana Cenarro
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV
- Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain
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2
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Bea AM, Cenarro A, Marco-Bened V, Laclaustra M, Martn C, Ibarretxe D, Pint X, Arrobas T, Vials C, Civeira F, Olmos S. Diagnosis of Familial Dysbetalipoproteinemia Based on the Lipid Abnormalities Driven by APOE2/E2 Genotype. Clin Chem 2023; 69:140-148. [PMID: 36644927 DOI: 10.1093/clinchem/hvac213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/14/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Familial dysbetalipoproteinemia (FDBL) is a monogenic disease due to variants in APOE with a highly variable phenotype. Current diagnostic lipid-based methods have important limitations. The objective is twofold: to define characteristics of dysbetalipoproteinemia (DBL) based on the analysis of APOE in patients from a lipid unit and in a sample from the general population, and to propose a screening algorithm for FDBL. METHODS Lipids and APOE genotype from consecutive unrelated subjects from Miguel Servet University Hospital (MSUH) (n 3603), subjects from the general population participants of the Aragon Workers Health Study (AWHS) (n 4981), and selected subjects from external lipid units (Ext) (n 390) were used to define DBL criteria and to train and validate a screening tool. RESULTS Thirty-five subjects from MSUH, 21 subjects from AWHS, and 31 subjects from Ext were APOE2/2 homozygous. The combination of non high-density lipoprotein cholesterol (non-HDLc)/apoB 1.7 plus triglycerides/apoB 1.35, in mg/dL (non-HDLc [mmol/L]/apolipoprotein B (apoB) [g/L] 4.4 and triglycerides [mmol/L]/apoB [g/L] 3.5), provided the best diagnostic performance for the identification of subjects with hyperlipidemia and APOE2/2 genotype (sensitivity 100 in the 3 cohorts, and specificity 92.8 [MSUH], 80.9 [AWHS], and 77.6 [Ext]). This improves the performance of previous algorithms. Similar sensitivity and specificity were observed in APOE2/2 subjects receiving lipid-lowering drugs. CONCLUSIONS The combination of non-HDLc/apoB and triglycerides/apoB ratios is a valuable tool to diagnose DBL in patients with hyperlipidemia with or without lipid-lowering drugs. FDBL diagnosis requires DBL and the presence of a compatible APOE genotype. Most adult APOE2/2 subjects express DBL, making FDBL as common as familial hypercholesterolemia in the population.
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Affiliation(s)
- Ana M Bea
- Hospital Universitario Miguel Servet, IIS Aragn, CIBERCV, Zaragoza, Spain
| | - Ana Cenarro
- Hospital Universitario Miguel Servet, IIS Aragn, CIBERCV, Zaragoza, Spain.,Molecular Research Laboratory, Instituto Aragones de Ciencias de la Salud (IACS), Zaragoza, Spain
| | - Victoria Marco-Bened
- Hospital Universitario Miguel Servet, IIS Aragn, CIBERCV, Zaragoza, Spain.,Departamento de Medicina, Psiquiatra y Dermatologa, Universidad de Zaragoza, Zaragoza, Spain
| | - Martn Laclaustra
- Hospital Universitario Miguel Servet, IIS Aragn, CIBERCV, Zaragoza, Spain.,Departamento de Medicina, Psiquiatra y Dermatologa, Universidad de Zaragoza, Zaragoza, Spain
| | - Csar Martn
- Fundacin Biofisika Bizkaia, Leioa, Spain.,Biofisika Institute (UPV/EHU, CSIC), Leioa, Spain.,Department of Biochemistry and Molecular Biology, Universidad del Pas Vasco UPV/EHU, Bilbao, Spain
| | - Daiana Ibarretxe
- Unitat de Medicina Vascular i Metabolisme (UVASMET) Hospital Universitari Sant Joan, IISPV, CIBERDEM, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Xavier Pint
- Unidad de Lpidos, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-Idibell, Universidad de Barcelona, CiberObn, Barcelona, Spain
| | - Teresa Arrobas
- Laboratorio de Nutricin y RCV, Laboratorio de Bioqumica Clnica, Hospital Virgen Macarena, Sevilla, Spain
| | - Clara Vials
- Endocrinology Department, Hospital Clnic de Barcelona, Barcelona, Spain.,Institut dInvestigacions Biomdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigacin Biomdica en Red Fisiopatologa de la Obesidad y Nutricin (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragn, CIBERCV, Zaragoza, Spain.,Departamento de Medicina, Psiquiatra y Dermatologa, Universidad de Zaragoza, Zaragoza, Spain
| | - Salvador Olmos
- Hospital Universitario Miguel Servet, IIS Aragn, CIBERCV, Zaragoza, Spain.,Aragon Institute of Engineering Research (I3A), Universidad de Zaragoza, Zaragoza, Spain
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Soedarman S, Kurnia KH, Prasetya ADB, Sasongko MB. Cholesterols, Apolipoproteins, and Their Associations with the Presence and Severity of Diabetic Retinopathy: A Systematic Review. VISION (BASEL, SWITZERLAND) 2022; 6:vision6040077. [PMID: 36548939 PMCID: PMC9785692 DOI: 10.3390/vision6040077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/28/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Serum apolipoproteins have been reported as a more significant marker for diabetic retinopathy (DR) compared with serum cholesterols. This article aims to review the associations between serum cholesterols and apolipoproteins, and the presence and severity of DR. The protocol of this systematic review was registered at the PROSPERO registry (CRD42022303331). We conducted a systematic search of literature published between 2011 to 2022 using the search terms "serum cholesterol" AND/OR "lipoprotein" AND/OR "apolipoprotein" AND/OR "diabetic retinopathy". Fifteen studies were included in this review. Six studies assessed the association between serum cholesterols, apolipoproteins, and the presence of DR. Three studies reported lower levels of apolipoprotein A1, and one study reported higher levels of apolipoprotein B in patients with DR. The remaining nine studies compared serum cholesterol and apolipoprotein levels according to DR severity. Patients with more severe grades of DR presented with lower apolipoprotein A1 in six (66.7%) studies, higher apolipoprotein B levels in seven (77.8%) studies, and a higher apolipoprotein B/apolipoprotein A1 ratio in six out of seven (85%) studies. In conclusion, serum apolipoproteins, in particular the apolipoprotein B/apolipoprotein A1 ratio, were a more consistent marker for DR severity compared with serum cholesterols.
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Affiliation(s)
- Soefiandi Soedarman
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- JEC Eye Hospitals & Clinics, Jakarta 10310, Indonesia
| | | | | | - Muhammad Bayu Sasongko
- Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Sardjito Eye Center, Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia
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4
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Khalil YA, Rabès JP, Boileau C, Varret M. APOE gene variants in primary dyslipidemia. Atherosclerosis 2021; 328:11-22. [PMID: 34058468 DOI: 10.1016/j.atherosclerosis.2021.05.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 01/10/2023]
Abstract
Apolipoprotein E (apoE) is a major apolipoprotein involved in lipoprotein metabolism. It is a polymorphic protein and different isoforms are associated with variations in lipid and lipoprotein levels and thus cardiovascular risk. The isoform apoE4 is associated with an increase in LDL-cholesterol levels and thus a higher cardiovascular risk compared to apoE3. Whereas, apoE2 is associated with a mild decrease in LDL-cholesterol levels. In the presence of other risk factors, apoE2 homozygotes could develop type III hyperlipoproteinemia (familial dysbetalipoproteinemia or FD), an atherogenic disorder characterized by an accumulation of remnants of triglyceride-rich lipoproteins. Several rare APOE gene variants were reported in different types of dyslipidemias including FD, familial combined hyperlipidemia (FCH), lipoprotein glomerulopathy and bona fide autosomal dominant hypercholesterolemia (ADH). ADH is characterized by elevated LDL-cholesterol levels leading to coronary heart disease, and due to molecular alterations in three main genes: LDLR, APOB and PCSK9. The identification of the APOE-p.Leu167del variant as the causative molecular element in two different ADH families, paved the way to considering APOE as a candidate gene for ADH. Due to non mendelian interacting factors, common genetic and environmental factors and perhaps epigenetics, clinical presentation of lipid disorders associated with APOE variants often strongly overlap. More studies are needed to determine the spectrum of APOE implication in each of the diseases, notably ADH, in order to improve clinical and genetic diagnosis, prognosis and patient management. The purpose of this review is to comment on these APOE variants and on the molecular and clinical overlaps between dyslipidemias.
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Affiliation(s)
- Yara Abou Khalil
- Laboratory for Vascular Translational Science (LVTS), INSERM U1148, Centre Hospitalo-Universitaire Xavier Bichat, Paris, France; Université de Paris, Paris, France; Laboratory of Biochemistry and Molecular Therapeutics (LBTM), Faculty of Pharmacy, Pôle Technologie- Santé (PTS), Saint-Joseph University, Beirut, Lebanon
| | - Jean-Pierre Rabès
- Laboratory for Vascular Translational Science (LVTS), INSERM U1148, Centre Hospitalo-Universitaire Xavier Bichat, Paris, France; Laboratory of Biochemistry and Molecular Genetics, Centre Hospitalo-Universitaire Ambroise Paré, HUPIFO, AP-HP. Paris-Saclay, Boulogne-Billancourt, France; UFR Simone Veil-Santé, UVSQ, Montigny-Le-Bretonneux, France
| | - Catherine Boileau
- Laboratory for Vascular Translational Science (LVTS), INSERM U1148, Centre Hospitalo-Universitaire Xavier Bichat, Paris, France; Université de Paris, Paris, France; Genetics Department, AP-HP, CHU Xavier Bichat, Paris, France
| | - Mathilde Varret
- Laboratory for Vascular Translational Science (LVTS), INSERM U1148, Centre Hospitalo-Universitaire Xavier Bichat, Paris, France; Université de Paris, Paris, France.
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Cenarro A, Bea AM, Gracia-Rubio I, Civeira F. Dysbetalipoproteinemia and other lipid abnormalities related to apo E. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2021; 33 Suppl 2:50-55. [PMID: 34006354 DOI: 10.1016/j.arteri.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022]
Abstract
Dysbetalipoproteinaemia (or type III hyperlipoproteinaemia) is a severe mixed hyperlipidaemia resulting from the accumulation of remnant chylomicron and VLDL particles in plasma, also called β-VLDL. It is caused by a defect in the recognition by hepatic LDL and lipoprotein receptor-related protein (LRP) of β-VLDL. Mutations in the APOE gene, especially in subjects homozygous for the ɛ2/ɛ2 allele, are responsible for this lack of receptor recognition. Dysbetalipoproteinaemia represents 2-5% of the mixed dyslipidaemias seen in Lipid Units, is highly atherogenic and predisposes to diffuse atheromatosis, either coronary, peripheral vascular, or carotid, so early diagnosis and treatment is necessary. The presence of hypertriglyceridaemia, with non-HDL cholesterol/apolipoprotein B ratios>1.43 (in mg/dL) followed by APOE genotyping is the method of choice in the diagnosis of dysbetalipoproteinaemia. It is a dyslipidaemia that responds well to hygienic-dietary treatment, although the combination of statin and fenofibrate is often necessary to achieve optimal control.
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Affiliation(s)
- Ana Cenarro
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - Ana M Bea
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - Irene Gracia-Rubio
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - Fernando Civeira
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España.
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Sathiyakumar V, Pallazola VA, Park J, Vakil RM, Toth PP, Lazo-Elizondo M, Quispe R, Guallar E, Banach M, Blumenthal RS, Jones SR, Martin SS. Modern prevalence of the Fredrickson-Levy-Lees dyslipidemias: findings from the Very Large Database of Lipids and National Health and Nutrition Examination Survey. Arch Med Sci 2020; 16:1279-1287. [PMID: 33224326 PMCID: PMC7667447 DOI: 10.5114/aoms.2019.86964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Five decades ago, Fredrickson, Levy, and Lees (FLL) qualitatively characterized clinical dyslipidemias with specific implications for cardiovascular and non-cardiovascular morbidity and mortality. They separated disorders of elevated cholesterol and triglycerides into five phenotypes (types I-V) based on their lipoprotein profile. Although clinicians generally consider them rare entities, modern FLL prevalence may be greater than previously reported. MATERIAL AND METHODS We performed a cross-sectional analysis in 5,272 participants from the 2011-2014 National Health and Nutrition Examination Survey and 128,506 participants from the Very Large Database of Lipids study with complete, fasting lipid profiles. We used a validated algorithm to define FLL phenotypes employing apolipoprotein B, total cholesterol, and triglycerides. RESULTS Overall prevalence of FLL phenotypes was 33.9%. FLL prevalence in the general population versus clinical lipid database was: type I (0.05 vs. 0.02%), type IIa (3.2 vs. 3.9%), type IIb (8.0 vs. 10.3%), type III (2.0 vs. 1.7%), type IV (20.5 vs. 24.1%), and type V (0.15 vs. 0.13%). Those aged 40-74 years had a higher overall prevalence compared to other age groups (p < 0.001) and men had overall higher prevalence than women (p < 0.001). Those with diabetes (51.6%) or obese BMI (49.0%) had higher prevalence of FLL phenotypes compared to those without diabetes (31.3%; p < 0.001) and normal BMI (18.3%; p < 0.001). CONCLUSIONS FLL phenotypes are likely far more prevalent than appreciated in clinical practice, in part due to diabetes and obesity epidemics. Given the prognostic and therapeutic importance of these phenotypes, their identification becomes increasingly important in the era of precision medicine.
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Affiliation(s)
- Vasanth Sathiyakumar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vincent A. Pallazola
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jihwan Park
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rachit M. Vakil
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter P. Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Community Hospital General Medical Center, Sterling, IL, USA
| | - Mariana Lazo-Elizondo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Renato Quispe
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maciej Banach
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Steven R. Jones
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seth S. Martin
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Ruhaak LR, Smit NPM, Suchiman HED, Pieterse MM, Romijn FPHTM, Beekman M, Cobbaert CM. MS-based proteomics: a metrological sound and robust alternative for apolipoprotein E phenotyping in a multiplexed test. Clin Chem Lab Med 2019; 57:e102-e104. [PMID: 30240356 DOI: 10.1515/cclm-2018-0782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/27/2018] [Indexed: 12/11/2022]
Affiliation(s)
- L Renee Ruhaak
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, TheNetherlands
| | - Nico P M Smit
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, TheNetherlands
| | - H Eka D Suchiman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, TheNetherlands
| | - Mervin M Pieterse
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, TheNetherlands
| | - Fred P H T M Romijn
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, TheNetherlands
| | - Marian Beekman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, TheNetherlands
| | - Christa M Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, TheNetherlands
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Zhang Q, Hu J, Hu Y, Ding Y, Zhu J, Zhuang C. Relationship between serum apolipoproteins levels and retinopathy risk in subjects with type 2 diabetes mellitus. Acta Diabetol 2018; 55:681-689. [PMID: 29623430 DOI: 10.1007/s00592-018-1136-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/26/2018] [Indexed: 02/03/2023]
Abstract
AIMS Prognostic significance of apolipoproteins in diabetic retinopathy risk has not been well investigated. The aim of this study was to reveal the relationship between the risk of diabetic retinopathy and the levels of several apolipoproteins and their ratios in a 10-year prospective cohort. METHODS A total of 1023 diabetic patients without retinopathy were selected from a 10-year hospital-based diabetic cohort. In this cohort, all subjects had type 2 diabetes. Blood samples were obtained, and serum levels of several apolipoproteins were measured. In the follow-up period, diabetic retinopathy was diagnosed by two ophthalmologists through a series of ophthalmologic examinations. A Cox proportional hazard analysis was adopted to determine the relationship between the risk of diabetic retinopathy and the levels of several apolipoproteins and their ratios. RESULTS In the follow-up period, 315 diabetic patients were suffered from diabetic retinopathy, and the remaining 708 patients did not. Baseline serum level of apoAI ≥ 7.4 μmol/L was related to the decreased risk of diabetic retinopathy (HR 0.86, 95% CI 0.70-0.99). Baseline levels of apoCIII ≥ 6.3 μmol/L, apoE ≥ 1.1 μmol/L, apoCIII-to-apoAI ratio ≥ 0.9 and apoE-to-apoAI ratio ≥ 0.2 were associated with the increased risk of this complication (HR 1.25, 95% CI 1.04-1.49; HR 1.23, 95% CI 1.03-1.47; HR 1.34, 95% CI 1.11-1.60; HR 1.21, 95% CI 1.01-1.46). CONCLUSION Elevated level of apoAI might be a protective factor for diabetic retinopathy. Increased levels of apoCIII, apoE, apoCIII-to-apoAI and apoE-to-apoAI ratios might be risk factors for this complication.
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Affiliation(s)
- Qianjin Zhang
- Department of Endocrinology, Shuyang People's Hospital, No. 9, Yingbin Road, Shucheng Town, Shuyang County, Suqian City, 223600, Jiangsu Province, China.
| | - Jine Hu
- Department of Endocrinology, Shuyang People's Hospital, No. 9, Yingbin Road, Shucheng Town, Shuyang County, Suqian City, 223600, Jiangsu Province, China
| | - Yichuan Hu
- Department of Endocrinology, Shuyang People's Hospital, No. 9, Yingbin Road, Shucheng Town, Shuyang County, Suqian City, 223600, Jiangsu Province, China
| | - Ying Ding
- Department of Endocrinology, Shuyang People's Hospital, No. 9, Yingbin Road, Shucheng Town, Shuyang County, Suqian City, 223600, Jiangsu Province, China
| | - Jingjing Zhu
- Department of Endocrinology, Shuyang People's Hospital, No. 9, Yingbin Road, Shucheng Town, Shuyang County, Suqian City, 223600, Jiangsu Province, China
| | - Changjiang Zhuang
- Department of Endocrinology, Shuyang People's Hospital, No. 9, Yingbin Road, Shucheng Town, Shuyang County, Suqian City, 223600, Jiangsu Province, China
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9
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Suvatha A, Kandi SM, Bhat DI, Rao N, Vazhayil V, Kasturirangan CG. Apolipoprotein E polymorphism and the risk of aneurysmal subarachnoid hemorrhage in a South Indian population. Cell Mol Biol Lett 2017; 22:25. [PMID: 29213291 PMCID: PMC5708094 DOI: 10.1186/s11658-017-0059-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/21/2017] [Indexed: 12/16/2022] Open
Abstract
Background The rupture of a brain aneurysm causes bleeding in the subarachnoid space. This is known as aneurysmal subarachnoid hemorrhage (aSAH). We evaluated the association of apolipoprotein E (APOE) polymorphism and the risk of aSAH in a South Indian population. Methods The study was performed on 200 subjects with aSAH and 253 healthy control subjects. Blood samples (5 ml) were used to isolate DNA and genotyping was performed for rs7412 and rs429358 using a Taqman allelic discrimination assay. Statistical software R.3.0.11 was used to statistically analyze the data and a p value < 0.05 was considered as statistically significant. Results We found a significant association with the risk of aSAH in ε3/ ε4 genetic model (OR = 1.91, 95% CI = 1.16-3.14, p = 0.01). However, in the other genetic models and allele frequency, there was no significant association with the risk of aSAH. In subtyping, we found a significant association of ε2 allele frequency with posterior communicating artery (PCOM) aneurysm (OR = 3.59, 95% CI = 1.11-11.64, p = 0.03). Conclusion Our results suggest that APOE polymorphism has an influence on the risk of aSAH in this South Indian population, specifically in the PCOM subtype.
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Affiliation(s)
- Arati Suvatha
- Department of Human Genetics, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029 India
| | - Sibin Madathan Kandi
- Department of Human Genetics, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029 India
| | - Dhananjaya Ishwara Bhat
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029 India
| | - Narasinga Rao
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029 India
| | - Vikas Vazhayil
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029 India
| | - Chetan Ghati Kasturirangan
- Department of Human Genetics, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029 India
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Autosomal dominant familial dysbetalipoproteinemia: A pathophysiological framework and practical approach to diagnosis and therapy. J Clin Lipidol 2017; 11:12-23.e1. [DOI: 10.1016/j.jacl.2016.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/26/2016] [Accepted: 10/02/2016] [Indexed: 11/18/2022]
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11
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Tsang HG, Rashdan NA, Whitelaw CBA, Corcoran BM, Summers KM, MacRae VE. Large animal models of cardiovascular disease. Cell Biochem Funct 2016; 34:113-32. [PMID: 26914991 PMCID: PMC4834612 DOI: 10.1002/cbf.3173] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 12/12/2022]
Abstract
The human cardiovascular system is a complex arrangement of specialized structures with distinct functions. The molecular landscape, including the genome, transcriptome and proteome, is pivotal to the biological complexity of both normal and abnormal mammalian processes. Despite our advancing knowledge and understanding of cardiovascular disease (CVD) through the principal use of rodent models, this continues to be an increasing issue in today's world. For instance, as the ageing population increases, so does the incidence of heart valve dysfunction. This may be because of changes in molecular composition and structure of the extracellular matrix, or from the pathological process of vascular calcification in which bone-formation related factors cause ectopic mineralization. However, significant differences between mice and men exist in terms of cardiovascular anatomy, physiology and pathology. In contrast, large animal models can show considerably greater similarity to humans. Furthermore, precise and efficient genome editing techniques enable the generation of tailored models for translational research. These novel systems provide a huge potential for large animal models to investigate the regulatory factors and molecular pathways that contribute to CVD in vivo. In turn, this will help bridge the gap between basic science and clinical applications by facilitating the refinement of therapies for cardiovascular disease.
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Affiliation(s)
- H G Tsang
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - N A Rashdan
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - C B A Whitelaw
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - B M Corcoran
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - K M Summers
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - V E MacRae
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
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Zhong L, Xie YZ, Cao TT, Wang Z, Wang T, Li X, Shen RC, Xu H, Bu G, Chen XF. A rapid and cost-effective method for genotyping apolipoprotein E gene polymorphism. Mol Neurodegener 2016; 11:2. [PMID: 26754117 PMCID: PMC4710020 DOI: 10.1186/s13024-016-0069-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/04/2016] [Indexed: 11/10/2022] Open
Abstract
Background Apolipoprotein E (ApoE) is a major cholesterol carrier and plays an important role in maintaining lipid homeostasis both in the periphery and brain. Human APOE gene is polymorphic at two single nucleotides (rs429358 and rs7412) resulting in three different alleles (ε2, ε3 and ε4). ApoE isoforms modulate the risk for a variety of vascular and neurodegenerative diseases; thus, APOE genotyping is crucial for predicting disease risk and designing individualized therapy based on APOE genotype. Results We have developed an APOE genotyping method that is based on allele-specific PCR methodology adapted to Real Time PCR monitored by TaqMan probe. Rather than using TaqMan probes specific for the two polymorphic sites, only one TaqMan probe is used as the polymorphic alleles are recognized by site-specific PCR primers. Each genotyping assay can be completed within 90 minutes and is applicable to high-throughput analysis. Using this protocol, we genotyped a total of 1158 human DNA samples and obtained a 100 % concordance with the APOE genotype determined by sequencing analysis. Conclusion The APOE genotyping assay we have developed is accurate and cost-effective. In addition, our assay can readily be applied to genotyping large sample numbers. Therefore, our APOE genotyping method can be used for assessing the risk for a variety of vascular and neurodegenerative diseases that have been reported to be associated with APOE polymorphism.
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Affiliation(s)
- Li Zhong
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Yong-Zhuang Xie
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Tian-Tian Cao
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Zongqi Wang
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Tingting Wang
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Xinxiu Li
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Rui-Chi Shen
- Fujian Institute of Subtropical Botany, Xiamen, 361006, China.
| | - Huaxi Xu
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
| | - Guojun Bu
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China. .,Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA.
| | - Xiao-Fen Chen
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, 361102, China.
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Hopkins PN, Brinton EA, Nanjee MN. Hyperlipoproteinemia type 3: the forgotten phenotype. Curr Atheroscler Rep 2015; 16:440. [PMID: 25079293 DOI: 10.1007/s11883-014-0440-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hyperlipoproteinemia type 3 (HLP3) is caused by impaired removal of triglyceride-rich lipoproteins (TGRL) leading to accumulation of TGRL remnants with abnormal composition. High levels of these remnants, called β-VLDL, promote lipid deposition in tuberous xanthomas, atherosclerosis, premature coronary artery disease, and early myocardial infarction. Recent genetic and molecular studies suggest more genes than previously appreciated may contribute to the expression of HLP3, both through impaired hepatic TGRL processing or removal and increased TGRL production. HLP3 is often highly amenable to appropriate treatment. Nevertheless, most HLP3 probably goes undiagnosed, in part because of lack of awareness of the relatively high prevalence (about 0.2% in women and 0.4-0.5% in men older than 20 years) and largely because of infrequent use of definitive diagnostic methods.
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Affiliation(s)
- Paul N Hopkins
- Cardiovascular Genetics, Department of Internal Medicine, University of Utah, 420 Chipeta Way, Room 1160, Salt Lake City, UT, 84108, USA,
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Koopal C, Retterstøl K, Sjouke B, Hovingh G, Ros E, de Graaf J, Dullaart R, Bertolini S, Visseren F. Vascular risk factors, vascular disease, lipids and lipid targets in patients with familial dysbetalipoproteinemia: A European cross-sectional study. Atherosclerosis 2015; 240:90-7. [DOI: 10.1016/j.atherosclerosis.2015.02.046] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 01/28/2015] [Accepted: 02/23/2015] [Indexed: 11/24/2022]
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Lopez MF, Krastins B, Ning M. The role of apolipoprotein E in neurodegeneration and cardiovascular disease. Expert Rev Proteomics 2014; 11:371-81. [DOI: 10.1586/14789450.2014.901892] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Li J, Chen Y, Wu H, Li L. Apolipoprotein E (Apo E) gene polymorphisms and recurrent pregnancy loss: a meta-analysis. J Assist Reprod Genet 2013; 31:139-48. [PMID: 24221911 DOI: 10.1007/s10815-013-0128-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 10/21/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Recently, a relationship between recurrent pregnancy loss (RPL) and Apolipoprotein E (Apo E) gene polymorphisms has been proposed. In order to investigate the real association between Apo E polymorphisms and RPL, our meta-analysis was carried out. METHODS We estimated the association with RPL risk under dominant and recessive models, in combination with the OR and RR with a 95% confidence interval (CI), which was used to assess the association between RPL and Apo E polymorphisms. RESULTS According to our criterion, there were 6 studies included. The dominant model used the E4/E3 group and the OR was 1.919 (95 %CI: 1.016-3.625, I(2) = 53.8%), the RR was 1.308 (95%Cl: 1.071-1.598) suggesting that carriers of the E4 allele would have a higher risk of causing spontaneous miscarriages. In addition, the OR was 0.727 (95%CI: 0.566-0.932, I(2) = 0.0%) and RR was 0.923 (95%CI: 0.867-0.982) in a fixed model for E3/E3 homozygotes versus other genotypes, suggesting that the Apo E3 polymorphism could be a protective factor. The OR was 1.365 (95% CI: 1.029-1.811, I(2) = 0 .0%) in a fixed model comparing the E2 allele with the E3 allele, suggesting that Apo E2 polymorphisms may contribute to RPL as a risk factor. Furthermore, after conducting sensitivity analysis in the E4/E3 group, the results showed this to be consistent and the OR was 2.249 (95%CI: 1.474-3.431). CONCLUSIONS There is a close association between RPL and Apo E gene polymorphisms. For RPL, the Apo E4 polymorphism could be a risk factor, the Apo E3 polymorphism may be a protective factor and the Apo E2 polymorphism may be another potential risk factor.
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Affiliation(s)
- Jie Li
- Guangxi Reproductive Medical Research Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, China
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Apolipoprotein E gene polymorphisms in Lebanese with hypercholesterolemia. Gene 2013; 522:84-8. [DOI: 10.1016/j.gene.2013.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 03/07/2013] [Indexed: 11/17/2022]
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Mendoza-Barberá E, Julve J, Nilsson SK, Lookene A, Martín-Campos JM, Roig R, Lechuga-Sancho AM, Sloan JH, Fuentes-Prior P, Blanco-Vaca F. Structural and functional analysis of APOA5 mutations identified in patients with severe hypertriglyceridemia. J Lipid Res 2013; 54:649-661. [PMID: 23307945 DOI: 10.1194/jlr.m031195] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
During the diagnosis of three unrelated patients with severe hypertriglyceridemia, three APOA5 mutations [p.(Ser232_Leu235)del, p.Leu253Pro, and p.Asp332ValfsX4] were found without evidence of concomitant LPL, APOC2, or GPIHBP1 mutations. The molecular mechanisms by which APOA5 mutations result in severe hypertriglyceridemia remain poorly understood, and the functional impairment/s induced by these specific mutations was not obvious. Therefore, we performed a thorough structural and functional analysis that included follow-up of patients and their closest relatives, measurement of apoA-V serum concentrations, and sequencing of the APOA5 gene in 200 nonhyperlipidemic controls. Further, we cloned, overexpressed, and purified both wild-type and mutant apoA-V variants and characterized their capacity to activate LPL. The interactions of recombinant wild-type and mutated apoA-V variants with liposomes of different composition, heparin, LRP1, sortilin, and SorLA/LR11 were also analyzed. Finally, to explore the possible structural consequences of these mutations, we developed a three-dimensional model of full-length, lipid-free human apoA-V. A complex, wide array of impairments was found in each of the three mutants, suggesting that the specific residues affected are critical structural determinants for apoA-V function in lipoprotein metabolism and, therefore, that these APOA5 mutations are a direct cause of hypertriglyceridemia.
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Affiliation(s)
| | - Josep Julve
- Institute for Biomedical Research (IIB) Sant Pau, 08025 Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, 08017 Barcelona, Spain
| | - Stefan K Nilsson
- Department of Medical Biosciences/Physiological Chemistry, Umeå University, SE90187, Sweden
| | - Aivar Lookene
- Department of Chemistry, Tallinn Technical University, Tallinn 12618, Estonia
| | | | - Rosa Roig
- Institute for Biomedical Research (IIB) Sant Pau, 08025 Barcelona, Spain
| | | | | | | | - Francisco Blanco-Vaca
- Institute for Biomedical Research (IIB) Sant Pau, 08025 Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, 08017 Barcelona, Spain; Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
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Metts B, Thatcher S, Lewis E, Karounos M, Cassis L, Smith R, Lodder RA. DDDAS Design of Drug Interventions for the Treatment of Dyslipidemia in ApoE -/- Mice. ACTA ACUST UNITED AC 2013; 2. [PMID: 25866829 DOI: 10.4172/2329-6631.1000107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Computational models of complex systems, such as signaling networks and biological systems, can be used to explain the behavior of such systems under various conditions. The large number of integrated processes and variables, and the nonlinearities inherent in the fundamental processes, make it difficult for scientists unassisted by computer simulations to effectively predict the consequences of a particular intervention. For this reason, computer simulation has become an important tool for generating hypotheses about the behavior of these systems that can then be tested in the laboratory and clinic. A dynamic data-driven application simulation (DDDAS) was designed by Biospherics to model complex metabolic disease pathways by testing potential binary therapies in simulations at various combinations of two points in the pathways. Since DDDAS chooses the most effective pair-wise combinations, this data-driven system allows for the implementation of real-time data to model or predict a measurement or event. By incorporating data dynamically rather than statically, the predictions and measurements become more reliable. Dyslipidemia, a common precursor to atherosclerosis, can be manifested by high triglycerides, increased apolipoprotein (Apo) B, high levels of LDL, and low levels of HDL. SPX106 and D-tagatose is a combination drug therapy composed of a carbohydrate (D-tagatose) and SPX106. D-tagatose has been studied for the treatment of diabetes for several years, and has the ability to lower blood insulin levels and to decrease glycogen formation. SPX106 is a natural substance that accelerates lipid catabolism and inhibits dyslipidemia. In apolipoprotein E knockout mice (ApoE-/-), this drug combination has been shown to significantly lower both the amount of atherosclerosis and blood cholesterol levels. This study used 26 male ApoE-/- mice (n=13 in each group, control and treated). The control group received the normal "Western" diet (Harlan TD88137) and the treatment group received a modified version in which the sucrose was replaced with D-tagatose and 1g of SPX106 was added for every kilogram of chow. Mice were fed the diet for 8 weeks and then sacrificed via cardiac puncture. Blood serum was analyzed for cholesterol concentration. A significant difference was observed between the control and treated groups for total cholesterol levels. FPLC separations were done on fractions from both control and treated groups. A significant difference between VLDL and HDL levels was found between the treated and control mice (p<0.05 for both). Aortas were also taken and preserved in formalin to be quantified for atherosclerosis. Aortic sinuses were frozen in OCT and sectioned using a cryostat and then quantified for atherosclerosis. Treated mice showed statistically significant reduction in atherosclerosis in the aortic arch (p<0.01), the thoracic aorta (p<0.05), and the aortic sinus (p<0.05) as well as a reduction of cholesterol (p<0.05).
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Affiliation(s)
| | - Sean Thatcher
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Eboni Lewis
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Mike Karounos
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Lisa Cassis
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Rebecca Smith
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, USA
| | - Robert A Lodder
- Department of Chemistry, University of Kentucky, USA ; Graduate Center for Nutritional Sciences, University of Kentucky, USA ; Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, USA ; Biospherics, Lexington, KY, USA
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Ravella K, Yang H, Gangula PRR. Impairment of gastric nitrergic and NRF2 system in apolipoprotein E knockout mice. Dig Dis Sci 2012; 57:1504-9. [PMID: 22302246 PMCID: PMC3677538 DOI: 10.1007/s10620-012-2070-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 01/20/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM Gastric motility dysfunction is most commonly seen in diabetic and idiopathic gastroparesis patients. Recently we reported that impaired nitrergic relaxation and a reduced NO (nitric oxide) bioavailability were responsible for gastric motility dysfunction in diabetic female rats. One of the main factors involved in the inactivation of the nitrergic system is oxidative stress commonly seen in diabetic patients. Hyperlipidemia may also be one of the detrimental causes for impaired gastric motility associated with diabetes. In the current study, we investigated whether apolipoprotein E knockout mice (ApoE-KO), an oxidative stress animal model with a hyperlipidemia burden, also displays an impaired nitrergic system. To test this, nitrergic relaxation (AUC/mg tissue) was measured at 2 Hz through electric field stimulation using gastric pyloric strips prepared from C57BL WT or ApoE-KO female mice. Protein expression was determined by Western blots. RESULTS Nitrergic relaxation was reduced in gastric strips from ApoE-KO versus WT mice. Protein levels of nNOS (neuronal nitric oxide synthase), GCH-1 (GTP cyclohydrolase 1), Nrf2 (nuclear factor E-2 related factor 2) and GCSc (glutamate-cysteine ligase catalytic) were also reduced in ApoE-KO compared to controls, with no significant change in GCSm (glutamate-cysteine ligase modifier) and HO-1 (heme oxygenase 1). The activities of DHFR (dihydrofolate reductase) and antioxidant enzymes were also reduced in ApoE-KO mice. CONCLUSIONS This novel study is the first to reveal that a deficiency in ApoE impairs gastric motility functions, and that hyperlipidemia and the suppression of selective antioxidants may be an underlying mechanism for this pathological change.
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Affiliation(s)
- Kalpana Ravella
- Department of Physiology, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Hong Yang
- Department of Physiology, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA
| | - Pandu R. R. Gangula
- Department of Physiology, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN 37208, USA,Center for Women’s Health Research, Meharry Medical College, Nashville, TN, USA
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Brown WV, Breslow J, Ballantyne C. Clinical use of genetic typing in human lipid disorders†. J Clin Lipidol 2012; 6:199-207. [DOI: 10.1016/j.jacl.2012.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 02/09/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
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Martín-Campos JM, Rico N, Bonet R, Mayoral C, Ordóñez-Llanos J, Blanco-Vaca F. Apolipoprotein A5 S19W May Play a Role in Dysbetalipoproteinemia in Patients with the Apo E2/E2 Genotype. Clin Chem 2006; 52:1974-5. [PMID: 16998123 DOI: 10.1373/clinchem.2006.070318] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sinnott BP, Mazzone T. Tuberous Xanthomas Associated with Olanzapine Therapy and Hypertriglyceridemia in the Setting of a Rare Apolipoprotein E Mutation. Endocr Pract 2006; 12:183-7. [PMID: 16690468 DOI: 10.4158/ep.12.2.183] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe a patient with tuberous xanthomas and high levels of cholesterol and triglycerides, who was found to have type III hyperlipoproteinemia (HLP) and a rare apolipoprotein E (apoE) mutation. METHODS We present a case report with extensive clinical, laboratory, and genetic documentation. RESULTS A 33-year-old African American man presented for evaluation of hypertriglyceridemia. His medical history was remarkable for schizophrenia necessitating ongoing olanzapine therapy for the past 6 years. A few months after olanzapine treatment was begun, he noted the development of nontender, firm, papular skin lesions on his elbows and knees. His family history was negative for lipid disorders or premature vascular disease. Physical examination revealed the presence of prominent tuberous xanthomas on both elbows and knees. Results of a lipid panel demonstrated a total cholesterol level of 374 mg/dL (9.7 mmol/L) and triglycerides of 828 mg/dL (9.3 mmol/L). A work-up for causes of secondary hyper-triglyceridemia was negative. Results of apoE genotyping by a commercial laboratory showed the E3/E3 genotype, based on gene sequencing at codons 112 and 158. Because the skin lesions were typical for type III HLP, his entire apoE gene was sequenced. This analysis revealed an apoE2/E2 (arginine 145 to cysteine) mutation, previously reported to be a rare cause of type III HLP in 5 patients of African descent. Triglyceride-lowering therapy with gem-fibrozil was initiated, in addition to lifestyle modification. At follow-up several months later, total cholesterol was 276 mg/dL (7.14 mmol/L) and triglycerides were 479 mg/dL (5.41 mmol/L). CONCLUSION We speculate that olanzapine therapy, with its known metabolic side effects, exacerbated this patient's underlying lipoprotein metabolic abnormality. To our knowledge, this is the first report of an association between olanzapine therapy and tuberous xanthomas and the sixth report of this rare apoE2/E2 (arginine 145 to cysteine) mutation in the literature.
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Affiliation(s)
- Bridget P Sinnott
- Division of Endocrinology, University of Illinois, Chicago, Illinois 60612, USA
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Cenarro A, Artieda M, Gonzalvo C, Meriño-Ibarra E, Arístegui R, Gañán A, Díaz C, Sol JM, Pocoví M, Civeira F. Genetic variation in the hepatic lipase gene is associated with combined hyperlipidemia, plasma lipid concentrations, and lipid-lowering drug response. Am Heart J 2005; 150:1154-62. [PMID: 16338252 DOI: 10.1016/j.ahj.2005.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Accepted: 02/07/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Combined hyperlipidemia (CHL) is a very frequent dyslipidemia, being lipid-lowering drugs often necessary in its management. Some genetic loci have been associated with CHL, and modulation of lipid-lowering treatment by genetic polymorphisms has been reported. We have investigated whether common polymorphisms in the hepatic lipase gene (LIPC) influence the baseline lipid concentration and the response to atorvastatin or bezafibrate in patients with CHL. METHODS Two genetic polymorphisms in LIPC (-514C-->T and +651A-->G) were determined by polymerase chain reaction and restriction analysis in 118 subjects of the ATOMIX (Atorvastatin in Mixed dyslipidemia) study who were randomized to treatment with either atorvastatin or bezafibrate and in 114 normolipidemic controls. RESULTS The -514T allele frequency was higher in the ATOMIX group (0.297) than in the control group (0.193) (P = .01). The -514T allele carriers in the control group showed higher high-density lipoprotein cholesterol (HDL-C) concentrations than the -514C homozygotes, 50.8 +/- 1.86 versus 45.9 +/- 1.40 mg/dL (P = .02). The +651G carriers in the ATOMIX group showed lower total cholesterol and low-density lipoprotein cholesterol than the +651A homozygotes, 274 +/- 3.72 and 181 +/- 3.50 mg/dL versus 289 +/- 4.0 and 194 +/- 3.76 mg/dL, respectively (P < .01). Homozygotes for the -514C allele on bezafibrate treatment had greater decrease in triglycerides and greater increase in HDL-C than -514T allele carriers after 12 months of bezafibrate treatment, -39.4% and +35.8% versus -25.5% and +20.4%, respectively (P = .080 and P = .007, respectively). CONCLUSIONS A higher frequency of the -514T allele of LIPC suggests a role of this locus in the pathogenesis of CHL. The -514T allele is associated with higher HDL-C concentration in normolipidemic population. The -514C-->T polymorphism modulates the lipid-lowering response to bezafibrate, with a better effect in homozygous CC subjects.
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Affiliation(s)
- Ana Cenarro
- Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Ghebranious N, Ivacic L, Mallum J, Dokken C. Detection of ApoE E2, E3 and E4 alleles using MALDI-TOF mass spectrometry and the homogeneous mass-extend technology. Nucleic Acids Res 2005; 33:e149. [PMID: 16204452 PMCID: PMC1243648 DOI: 10.1093/nar/gni155] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Apolipoprotein (Apo) E is one of the five main types of blood lipoproteins (A–E). It is synthesized primarily in the liver and brain and helps in transporting lipids from one place to another as well as facilitates the clearing of dietary fats, such as triglycerides, from the blood. The ApoE gene exists in three different forms: E2, E3 and E4. E3 is considered to be the normal form. Variants of the ApoE gene have been associated with various diseases. Developing an assay for the genotyping of ApoE variants for use both in clinical and large cohort based association settings would be extremely valuable and would require the use of a platform that has high-throughput capabilities and is highly accurate. Here we describe an assay for the simultaneous genotyping of the ApoE variants in a single bi-plex reaction and a single well using the matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and the homogeneous mass-extend (hME) technology. The assay is robust, highly accurate and suitable for both clinical applications and for the genotyping of large disease cohorts. Moreover, the prevalence of ApoE variants in a cohort of Caucasians from the central Wisconsin area is outlined.
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Affiliation(s)
- Nader Ghebranious
- Molecular Diagnostics Genotyping Laboratory, Marshfield Clinic, Marshfield, WI 54449, USA.
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Blom DJ, O'Neill FH, Marais AD. Screening for dysbetalipoproteinemia by plasma cholesterol and apolipoprotein B concentrations. Clin Chem 2005; 51:904-7. [PMID: 15855667 DOI: 10.1373/clinchem.2004.047001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Dirk J Blom
- Division of Lipidology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Hirayama S, Miida T, Obayashi K, Yamazaki F, Yamazaki-Sakurai M, Ito M, Saito Y, Hanyu O, Suzuki K, Aizawa Y. Effect of apolipoprotein E (apoE) phenotype on the apoE content of CSF-HDL in children. Clin Chim Acta 2005; 356:110-6. [PMID: 15936307 DOI: 10.1016/j.cccn.2005.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Revised: 01/10/2005] [Accepted: 01/10/2005] [Indexed: 11/23/2022]
Abstract
BACKGROUND The majority of the lipoprotein in cerebrospinal fluid (CSF) is apolipoprotein E (apoE)-containing HDL. Since neuronal cells express lipoprotein receptors which recognize apoE, apoE in CSF-HDL is believed to be important for the development of central nervous system (CNS) in children. In adults, the apoE phenotype affects the plasma apoE concentration and the epsilon 4 allele is a risk factor for Alzheimer's disease. Due to the requirement for CNS development, we examined whether the apoE phenotype affects the composition and concentration of CSF-HDL in children. METHODS We determined the apoE phenotype in 107 neurologically normal subjects, including 67 children (<20 years), by isoelectronic focusing. We also measured apoE, total cholesterol (TC), and phospholipid (PL) concentrations in the CSF. RESULTS The respective frequencies of apoE4/3, E3/3 and E3/2 were 16.4%, 77.6%, and 6.0%. The allele frequencies of epsilon 4, epsilon 3, and epsilon 2 were 0.082, 0.888, and 0.030, respectively. There were no significant differences in the CSF-apoE, TC, or PL concentrations or the apoE/PL ratio among the apoE phenotypes. However, the CSF-apoE/PL ratio was significantly higher in children than in adults. CONCLUSION The apoE phenotype does not affect the composition or concentration of CSF-HDL in children. We speculate that an apoE4 carrier is prevented in childhood from the impaired development of central nervous system by CSF-HDL enriched with apoE.
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Affiliation(s)
- Satoshi Hirayama
- Division of Endocrinology and Metabolism, Department of Homeostatic Regulation and Developments, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi 1-757, Niigata City, Niigata 951-8510, Japan
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29
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Rolleri M, Vivona N, Emmanuele G, Cefalù AB, Pisciotta L, Guido V, Noto D, Fiore B, Barbagallo CM, Notarbartolo A, Travali S, Bertolini S, Averna MR. Two Italian kindreds carrying the Arg136-->Ser mutation of the Apo E gene: development of premature and severe atherosclerosis in the presence of epsilon 2 as second allele. Nutr Metab Cardiovasc Dis 2003; 13:93-99. [PMID: 12929622 DOI: 10.1016/s0939-4753(03)80024-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Type III hyperlipoproteinemia, or dysbetalipoproteinemia, is commonly associated with apolipoprotein E2 homozygosity (Cys112, Cys158). Apo E2-Christchurch (Arg136-->Ser), a rare mutation of the Apo E gene, located in the receptor-binding domain of the protein, has been found to be associated in the vast majority of cases of dysbetalipoproteinemia. METHODS AND RESULTS This is the first report of two Italian kindreds carrying the Arg136-->Ser mutation. One family is a four-generation kindred from Genoa (Liguria, Italy) with a high rate of mortality due to coronary artery disease: the proband was a 51-year-old woman with previous myocardial infarction and residual angina, severe carotid atherosclerosis, peripheral arterial vascular disease and arterial hypertension. The other family was identified in Palermo (Sicily, Italy): the proband was an overweight 62-year-old man with a mixed form of hyperlipidemia. The mutation, which was identified by means of Apo E genotyping followed by direct sequencing, co-segregated with the same haplotype in the two families. CONCLUSIONS The family histories and clinical examinations of these subjects clearly show that the Apo E Arg136-->Ser variant fully expresses a type III phenotype in association with a second allele coding for Apo E2, and only partially in association with a second allele coding for Apo E4.
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Affiliation(s)
- M Rolleri
- Department of Internal Medicine, University of Genoa, Genoa, Italy
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30
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Lin HP, Kao JT. Apolipoprotein epsilon 2/3 genotype and type III hyperlipoproteinemia among Taiwanese. Clin Chim Acta 2003; 330:173-8. [PMID: 12636937 DOI: 10.1016/s0009-8981(03)00050-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Type III hyperlipoproteinemia (HLP) is a genetic disorder of lipid metabolism in humans that predisposes affected subjects to the premature development of atherosclerosis. Most type III HLP occurs in homozygous carriers of apolipoprotein (apo) E2. The aims of this study were to determine the frequencies of different apo E genotypes in type III HLP in Taiwanese and to assess the possibility of apo E mutants in these patients. MATERIALS AND METHODS Four hundred and seven patients with hyperlipoproteinemia were recruited. Electrophoresis, apo E genotyping and sequencing were performed. RESULTS Of the 407 hyperlipoproteinemia, 8 were identified as type III HLP. In contrast to reports of high apo epsilon 2/2 genotype prevalence, only two of the type III HLP subjects were of the apo epsilon 2/2 genotype (25%). Fifty percent of the type III HLP were of apo epsilon 2/3 genotype. This observation was further reflected in a lower frequency of the epsilon 2 allele (0.563) and higher epsilon 3 allele (0.375) frequency. No rare apo E variant was found by direct sequencing. CONCLUSION The most common genotype of type III HLP in Taiwan was apo epsilon 2/3 instead of apo epsilon 2/2.
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Affiliation(s)
- Hsing-Pei Lin
- Graduate Institute of Medical Technology, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
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31
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van Dam M, Zwart M, de Beer F, Smelt AHM, Prins MH, Trip MD, Havekes LM, Lansberg PJ, Kastelein JJP. Long term efficacy and safety of atorvastatin in the treatment of severe type III and combined dyslipidaemia. Heart 2002; 88:234-8. [PMID: 12181212 PMCID: PMC1767327 DOI: 10.1136/heart.88.3.234] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Fibric acid derivatives and HMG-CoA reductase inhibitors are effective in combination for treating patients with familial dysbetalipoproteinaemia and severe combined dyslipidaemia, but combination therapy affects compliance and increases the risk of side effects. AIM To evaluate the efficacy and safety of monotherapy with atorvastatin, an HMG-CoA reductase inhibitor with superior efficacy in lowering low density lipoprotein cholesterol and triglyceride concentrations, in patients with dysbetalipoproteinaemia and severe combined dyslipidaemia. METHODS Atorvastatin was tested as single drug treatment in 36 patients with familial dysbetalipoproteinaemia and 23 patients with severe combined dyslipidaemia. RESULTS After 40 weeks of 40 mg atorvastatin treatment decreases in total cholesterol, triglycerides, and apolipoprotein B of 40%, 43%, and 41%, respectively, were observed in the combined dyslipidaemia group, and of 46%, 40%, and 43% in the dysbetalipoproteinaemic patients. Target concentrations of total cholesterol (< 5 mmol/l) were reached by 63% of the patients, and target concentrations of triglycerides (< 3.0 mmol/l) by 66%. Treatment with atorvastatin was well tolerated and no serious side effects were reported. CONCLUSIONS Atorvastatin is very effective as monotherapy in the treatment of familial dysbetalipoproteinaemia and severe combined dyslipidaemia.
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Affiliation(s)
- M van Dam
- Department of Vascular Medicine, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, Netherlands
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32
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Abstract
Type III hyperlipoproteinemia (HLP) is usually associated with homozygosity for apolipoprotein (apo) E2 (Arg112 --> Cys, Arg158 --> Cys). This common apo E isoform is defective in its binding to lipoprotein receptors. However, other rare mutations in the apo epsilon gene may also, in part dominantly, predispose to the disease. In order to assess the prevalence of rare apo E variants and mutations in the apo epsilon gene in Germany, we examined apo epsilon genotypes by restriction isotyping (RI) and apo E phenotypes by isoelectric focusing (IEF) in 107 German patients with type III HLP. Concordance between apo epsilon genotype and apo E phenotype was observed in 101 subjects (94.4%). Six individuals (5.6%) had genotypes and phenotypes other than E2/2. One subject was apparently homozygous for apo E2 by IEF, but heterozygous for epsilon3/2 by RI. Sequencing of the apo epsilon gene disclosed a hitherto undescribed point mutation (TGG --> TGA) at the third position of the codon for amino acid 20 (Trp), introducing a premature termination codon. This is the first study demonstrating that in the German population type III HLP is mainly associated with homozygosity for apo E2 (Arg112 --> Cys, Arg158 --> Cys) and that discrepancies between apo epsilon genotype and apo E phenotype are rare in this genetic condition.
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Affiliation(s)
- G Feussner
- Medizinische Universitätsklinik, Heidelberg, Germany.
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33
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Vialettes B, Reynier P, Atlan-Gepner C, Mekki N, Lesluyes-Mazzochi L, Luc G, Lairon D, Malthiery Y. Dietary fat clearance in type V hyperlipoproteinaemia secondary to a rare variant of human apolipoprotein E: the apolipoprotein E3 (Arg 136-->Ser). Br J Nutr 2000; 83:615-22. [PMID: 10911769 DOI: 10.1017/s0007114500000787] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This present case report describes two siblings with severe type V hyperlipoproteinaemia, diagnosed very early in life and due to the combination of the common apolipoprotein (Apo) E2 allele and rare mutant variant of ApoE, ApoE3 (Arg 136-->Ser). Phenotyping of ApoE falsely identified E2/E2 phenotype. The presence of mutated ApoE was suspected on an unusual restriction polymorphism of a Hha 1 restriction site and confirmed by sequence analysis of the cloned polymerase chain reaction fragment of exon 4 and familial segregation study. The severity of the hypertriacylglycerolaemia was modulated by the lipid content of the diet. A low-fat diet enriched in medium-chain triacylglycerol (TAG) decreased but did not normalize plasma TAG levels in both affected patients of the pedigree. A standardized lipid-enriched test meal showed a marked impairment of TAG-rich lipoprotein (TRL) clearance, especially the exogeneous TRL bearing ApoB-48 which still represented 79% of total TRL 7 h after the fat load. Finally, differences between the male and female siblings with the existence of a consanguine relationship in their parents suggested the involvement of other genetic factors in modulating the severity of phenotypic expression. This observation reinforces the usefulness of genotyping of ApoE for the characterization of genetic hypertriacylglycerolaemia and selection of the appropriate diet and treatment.
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Affiliation(s)
- B Vialettes
- Service de Nutrition, Maladies Métaboliques, Endocrinologie, Hôpital Sainte Marguerite, Université de la Méditerranée, Marseille, France.
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34
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Escolà-Gil JC, Jorba O, Julve-Gil J, González-Sastre F, Ordóñez-Llanos J, Blanco-Vaca F. Pitfalls of Direct HDL-Cholesterol Measurements in Mouse Models of Hyperlipidemia and Atherosclerosis. Clin Chem 1999. [DOI: 10.1093/clinchem/45.9.1567] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Joan Carles Escolà-Gil
- Servei de Bioquímica and
- Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, C/Antoni M. Claret 167, 08025 Barcelona, Spain
| | | | - Josep Julve-Gil
- Servei de Bioquímica and
- Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, C/Antoni M. Claret 167, 08025 Barcelona, Spain
| | - Francesc González-Sastre
- Servei de Bioquímica and
- Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, 0825 Barcelona, Spain
| | - Jordi Ordóñez-Llanos
- Servei de Bioquímica and
- Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, 0825 Barcelona, Spain
| | - Francisco Blanco-Vaca
- Servei de Bioquímica and
- Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, C/Antoni M. Claret 167, 08025 Barcelona, Spain
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Civeira F, Cenarro A, Ferrando J, Puzo J, Garcia-Otín AL, Mozas P, Pocoví M. Comparison of the hypolipidemic effect of gemfibrozil versus simvastatin in patients with type III hyperlipoproteinemia. Am Heart J 1999; 138:156-62. [PMID: 10385780 DOI: 10.1016/s0002-8703(99)70262-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Type III hyperlipoproteinemia is characterized by the accumulation of chylomicron and very low density lipoprotein (VLDL) remnants. Individuals with this disorder have a high risk of premature atherosclerosis, and hypolipidemic drugs are useful in their management. METHODS We compared, in a double-blind, placebo-controlled, randomized crossed study, the effects of gemfibrozil (1200 mg/day) and simvastatin (20 mg/day) on lipids, apolipoprotein AI, apolipoprotein B, and apolipoprotein E and on lipids and apolipoprotein B content in VLDL, intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) in 10 patients with type III hyperlipoproteinemia. RESULTS Levels of total cholesterol, VLDL cholesterol, IDL cholesterol, and apolipoprotein B decreased with both drugs. Larger reductions in triglycerides (109 +/- 28.2 mg/dL, P =.005), VLDL cholesterol (24.7 +/- 10.9 mg/dL, P =.05), and VLDL triglycerides (86.3 +/- 20.2 mg/dL, P =.003) were obtained with gemfibrozil compared with simvastatin. LDL cholesterol reduction was more effective with simvastatin than with gemfibrozil (44.3 +/- 17.1 mg/dL, P =.03). HDL cholesterol after gemfibrozil was 5.71 +/- 2.37 mg/dL higher than after simvastatin. CONCLUSIONS In patients with type III hyperlipoproteinemia gemfibrozil is more effective in reducing total triglyceride and VLDL lipid levels than simvastatin, and simvastatin is better in reducing LDL cholesterol than gemfibrozil is. IDL and apolipoprotein E levels were reduced similarly with both drugs.
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Affiliation(s)
- F Civeira
- Hospital Miguel Servet, Zaragoza, Spain.
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36
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Joven J, Simó JM, Vilella E, Camps J, Masana L, de Febrer G, Camprubí M, Richart C, Bardaji A, Casao E, Pocovi M, Civeira F. Lipoprotein(a) and the significance of the association between platelet glycoprotein IIIa polymorphisms and the risk of premature myocardial infarction. Atherosclerosis 1998; 140:155-9. [PMID: 9733226 DOI: 10.1016/s0021-9150(98)00076-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Platelet glycoprotein IIb/IIIa may be involved in the pathogenesis of myocardial infarction as the key element in platelet aggregation and as the binding site of lipoprotein(a) to platelets, inhibiting plasminogen binding and activation. Recently, a strong association between the P1A2 polymorphism of the glycoprotein IIIa gene and acute coronary thrombosis has been reported. although this has not been confirmed. In an associated study, we determined plasma lipoprotein levels, the apo E genotype and the P1A genotype in 250 males under 55 years with myocardial infarction and they were compared with 250 age- and sex-matched controls. Patients showed an over-representation of the epsilon3/4 genotype with respect to the control group. We found that there were no differences in the allelic frequency of P1A2 between case patients and age-matched controls (chi2 = 0.05, P = 0.92) and that subjects bearing the P1A2 allele showed higher plasma lipoprotein(a) concentration than p1A1/P1A1 individuals. Therefore, in this population there is no association between carriage of p1A2 allele and increased risk of myocardial infarction but the carriage of P1A2 is associated with higher plasma Lp(a) concentration.
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Affiliation(s)
- J Joven
- Unitat clinico-experimental d'investigació Hospital Universitari de Sant Joan-Universitat Rovira i Virgili, Reus, Spain.
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