Effect of APOE Genotype on Lipid Levels in Patients With Coronary Heart Disease During a 3-Week Inpatient Rehabilitation Program

Apolipoprotein E e4 and Cognitive Function: A Modifiable Association Results from Two Independent Cohort Studies

BACKGROUND

The apolipoprotein E (APOE) e4 genetic polymorphism is a major risk factor for Alzheimer' s disease, hence the possible prevention of its detrimental effects on cognition is of high relevance.

METHODS

We used linear regression models to assess associations of APOE e4 with cognitive performance in a population-based cohort study (n = 1,434) and in a cohort of patients with coronary heart disease (n = 366), and restricted cubic splines to explore dose-response relationships between serum cholesterol levels and cognition depending on APOE polymorphism.

RESULTS

The association of APOE e4 with cognitive function was strongly amplified in the presence of hypercholesterolemia and cardiovascular disease in both independent cohorts; hypercholesterolemia was associated with cognitive function only among APOE e4 carriers in the presence of cardiovascular disease. The interaction effect between APOE genotype and hypercholesterolemia was statistically significant in both cohorts.

CONCLUSIONS

The detrimental effects of APOE e4 polymorphism on cognition may strongly depend on modifiable risk factors.

Effect of apolipoprotein E polymorphism on statin-induced decreases in plasma lipids and cardiovascular events

Hypercholesterolemia or dyslipidemia is an independent risk factor for cardiovascular disease and statins (inhibitors of a key enzyme of cholesterol synthesis, 3-hydroxymethyl glutaryl coenzyme A reductase) are the drugs of choice for decreasing plasma cholesterol. It has been estimated that genetic factors can explain 40%-60% of final cholesterol concentrations and approximately 70% of the efficacy of statin treatment. The gene most often analyzed in the context of statin efficacy is the gene for apolipoprotein E (APOE). This review summarizes evidence of the association between variations in the APOE gene locus and the response of plasma lipids to statin therapy. Although the results are not consistent, carriers of the APOE4 allele seems to be less responsive to statins than carriers of APOE2 and APOE3 alleles. This effect is partially context-dependent (gene-gender interactions; gene-nutrition and gene-smoking interactions have not yet been studied) and the absolute differences vary between different population groups.