XbaI polymorphism in DNA at the apolipoprotein B locus is associated with myocardial infarction (MI)

Distribution of polymorphism rs693 of ApoB gene in a sample of Colombian Caribbeans

INTRODUCTION

Several studies have reported that the single nucleotide polymorphism rs693 of Apo lipoprotein B gene is associated with high levels of plasma lipids and high body mass index, which are risk factors for cardiovascular diseases. The distribution of this single nucleotide polymorphism and its association with the phenotype depend on the genetic background of each population.

OBJECTIVE

To evaluate the distribution of single nucleotide polymorphism rs693 and its association with lipid profile and body mass index in a sample of Colombian Caribbeans.

METHODS

108 non-related adult subjects of both gender were included in this study. Body mass index and lipid profile that included total cholesterol, triglycerides, Low Density Lipoprotein and High Density Lipoprotein were determined. The single nucleotide polymorphism rs693 was determined by Polymerase Chain Reaction/Restriction Fragment Length Polymorphism from genomic DNA followed by digestion with the restriction enzyme XbaI. The chi-square test was used to analyze the genotype distribution of rs693 and the genotype-phenotype association was evaluated through different inheritance model.

RESULTS

The genotype frequencies for single nucleotide polymorphism rs693 were CC (45.0%), TT (16.5%) and CT (38.5%). The allele frequencies were C (64.0%) and T (36.0%). The single nucleotide polymorphism was in Hardy-Weinberg equilibrium in the studied sample. No association of the single nucleotide polymorphism rs693 with lipid profile nor the body mass index was found (p >0.05).

CONCLUSION

There is no significant association between single nucleotide polymorphism rs693 and body mass index nor lipid profile, in a sample of Colombian Caribbeans.

Associations of the APOB rs693 and rs17240441 polymorphisms with plasma APOB and lipid levels: a meta-analysis

BACKGROUND

The associations of the apolipoprotein B gene (APOB) rs693 and rs17240441 polymorphisms with plasma levels of APOB and lipids have been widely explored, but the results were inconclusive. This meta-analysis aimed to clarify the associations of the rs693 and rs17240441 polymorphisms with fasting APOB and lipid levels.

METHODS

Sixty-one studies (50,018 subjects) and 23 studies (8425 subjects) were respectively identified for the rs693 and rs17240441 polymorphisms by searching in PubMed, Google Scholar, Web of Science, Cochrane Library, Wanfang, VIP and CNKI databases. The following information was collected for each study: first author, age, gender, ethnicity, health condition, sample size, genotyping, lipid assay method, mean and standard deviation or standard error of APOB and lipid variables by genotypes. A dominant model was used for this meta-analysis.

RESULTS

The carriers of the rs693 variant allele (T) had higher levels of APOB [standardized mean difference (SMD) = 0.26, 95% confidence interval (CI) = 0.16-0.36, P < 0.01], triglycerides (TG) (SMD = 0.12, 95% CI = 0.05-0.20, P < 0.01), total cholesterol (TC) (SMD = 0.24, 95% CI = 0.17-0.30, P < 0.01) and low-density lipoprotein cholesterol (LDL-C) (SMD = 0.22, 95% CI = 0.14-0.30, P < 0.01), and lower levels of high-density lipoprotein cholesterol (HDL-C) (SMD = -0.06, 95% CI = -0.11-0.01, P = 0.01) than the non-carriers. The carriers of the rs17240441 deletion allele had higher levels of APOB (SMD = 0.13, 95% CI = 0.06-0.20, P < 0.01), TC (SMD = 0.17, 95% CI = 0.07-0.26, P < 0.01) and LDL-C (SMD = 0.15, 95% CI = 0.07-0.23, P < 0.01) than the non-carriers.

CONCLUSIONS

The rs693 polymorphism is significantly associated with higher levels of APOB, TG, TC and LDL-C, and lower levels of HDL-C. The rs17240441 polymorphism is significantly associated with higher levels of APOB, TC and LDL-C. Further studies are needed to elucidate the underlying mechanisms.

Association between apolipoprotein B gene polymorphisms and the risk of coronary heart disease (CHD): an update meta-analysis

OBJECTIVE

Polymorphisms in the apolipoprotein B (apoB) gene have been reported to be associated with coronary heart disease (CHD). However, the results on this topic are conflicting. The present study aims to derive a more precise estimation of the relationship between CHD and apoB genetic polymorphisms by meta-analysis.

METHODS

We identified a total of 54 studies involving 7236, 10,912, and 14,102 individuals, respectively, for EcoRI, XbaI, and SpIns/Del polymorphisms by searching in PubMed, Web of Science, Google Scholar, the Cochrane Library, Wanfang Data, SinoMed, and CNKI. We utilized RevMan 5.0 software to perform the meta-analyses.

RESULTS

A significant statistical association between apoB EcoRI polymorphism and CHD was observed under an allelic (p = 0.001, odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.12-1.57), dominant (p = 0.005, OR = 1.22, 95% CI = 1.06-1.40), and recessive (p = 0.04, OR = 1.33, 95% CI = 1.01-1.74) model. We also found similar association of apoB SpIns/Del polymorphism with CHD. However, we did not find association between apoB XbaI polymorphism and CHD.

CONCLUSION

The current meta-analysis found an association of EcoRI polymorphism and SpIns/Del polymorphism with an increased risk of CHD. No significant association between apoB XbaI polymorphism and CHD we observed in the present study.

ApoB gene SpIns/Del, XbaI polymorphisms and myocardial infarction: a meta-analysis of 7169 participants

BACKGROUND

Apolipoprotein B (ApoB) gene signal peptide insertion/deletion (SpIns/Del, I/D) and XbaI polymorphisms have been associated with susceptibility to myocardial infarction (MI). However, the results of studies on this association are still controversial.

OBJECTIVE AND METHODS

This study explored reports published from 1986 to 2008 regarding the association of ApoB gene SpIns/Del and XbaI polymorphisms with MI. A meta-analysis including 7169 participants from 19 individual studies was performed. The pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were evaluated by fixed-effect or random-effect models.

RESULTS

A significant relationship between ApoB SpIns/Del gene polymorphism and MI was found under allelic (OR: 1.270, 95% CI: 1.090-1.480, P = 0.002), recessive (OR: 1.360, 95% CI: 1.130-1.630, P = 0.0009), dominant (OR: 1.091, 95% CI: 1.037-1.146, P = 0.001), homozygous (OR: 1.610, 95% CI: 1.330-1.950, P <0.00001) and heterozygous (OR: 1.081, 95% CI: 1.020-1.146, P = 0.009) genetic models. A marginal relationship between ApoB XbaI polymorphism and MI was found under a dominant genetic model (OR: 1.083, 95% CI: 1.004-1.168, P = 0.039). No significant association was detected under other genetic models (P >0.05). However, in the non-European subgroup analysis, increased MI risk emerged under all genetic models (P <0.05).

CONCLUSION

ApoB SpIns/Del gene polymorphism was positively associated with increased MI risk. D allele and DD genotype carriers might be predisposed to MI susceptibility. The ApoB XbaI gene polymorphism locus had a significant positive association with increased MI risk only in the non-European population. T allele and TT genotype carriers might be susceptible to MI in the non-European population. On the contrary, the ApoB gene XbaI restriction fragment length polymorphism was not associated with increased MI risk in the entire population, particularly in the European population.

The roles of genetic polymorphisms and human immunodeficiency virus infection in lipid metabolism

Dyslipidemia has been frequently observed among individuals infected with human immunodeficiency virus type 1 (HIV-1), and factors related to HIV-1, the host, and antiretroviral therapy (ART) are involved in this phenomenon. This study reviews the roles of genetic polymorphisms, HIV-1 infection, and highly active antiretroviral therapy (HAART) in lipid metabolism. Lipid abnormalities can vary according to the HAART regimen, such as those with protease inhibitors (PIs). However, genetic factors may also be involved in dyslipidemia because not all patients receiving the same HAART regimen and with comparable demographic, virological, and immunological characteristics develop variations in the lipid profile. Polymorphisms in a large number of genes are involved in the synthesis of structural proteins, and enzymes related to lipid metabolism account for variations in the lipid profile of each individual. As some genetic polymorphisms may cause dyslipidemia, these allele variants should be investigated in HIV-1-infected patients to identify individuals with an increased risk of developing dyslipidemia during treatment with HAART, particularly during therapy with PIs. This knowledge may guide individualized treatment decisions and lead to the development of new therapeutic targets for the treatment of dyslipidemia in these patients.

Genetic variations of the apolipoprotein B gene in Turkish patients with coronary artery disease

BACKGROUND

The results of studies that clarify the association of genetic markers at the apolipoprotein B (apo B) gene (EcoRI and XbaI polymorphisms) with coronary artery disease (CAD) are not consistent and suggest that the effect is context dependent (dependent on ethnicity and sex). The present study represents the first investigation of the apo B gene polymorphisms in Turkish patients with CAD and their influence on lipid levels.

AIM

The study investigated the association of apo B gene EcoRI and XbaI polymorphisms with CAD and with variation in lipid levels (total cholesterol (T-Chol), high-density lipoprotein cholesterol (HDL-Chol), low-density lipoprotein cholesterol (LDL-Chol), and triacylglycerol (TAG)).

SUBJECTS AND METHODS

The study group was composed of 150 individuals with angiographically documented CAD and 100 angiographically proven to be healthy controls. PCR-RFLP was used to determine the DNA polymorphisms of the apo B gene.

RESULTS

The frequencies of apo B genotypes detected with EcoRI (AA, AG, GG) and XbaI (CC, CT, TT) did not differ significantly between case and control subjects. A significant association between EcoRI genotypes and T-Chol (p < or = 0.05), and LDL-Chol (p < or = 0.001) was observed only in CAD patients. Patients with the AA genotype had higher levels of serum T-Chol and LDL-Chol compared with AG. With logistic regression analysis the XbaI TT genotype was found to be associated with CAD prevention. However, no significant differences in lipid variables were determined for the XbaI polymorphisms in the patients with CAD.

CONCLUSIONS

Apo B EcoRI genotypes were not found as risk factors for CAD, whereas XbaI TT genotype was detected to prevent against CAD in our study group.

Apolipoprotein A-I/C-III/A-IV SstI and apolipoprotein B XbaI polymorphisms and their association with carotid artery intima-media thickness in the Finnish population. The Cardiovascular Risk in Young Finns Study

Apolipoprotein A-I/C-III/A-IV (apoA-I/C-III/A-IV) SstI and apolipoprotein B (apoB) XbaI polymorphisms have been shown to affect serum low-density lipoprotein (LDL) cholesterol concentrations in a sample of Finnish children. We studied whether these polymorphism are associated with carotid artery intima-media thickness (IMT), a marker of pre-clinical atherosclerosis, measured in the same subjects during their adulthood. A random sub-sample of 214 individuals from the "Cardiovascular Risk in Young Finns" study, for whom genotypes, cardiovascular risk factor data and carotid artery IMT measured in 2001 were available, were studied. Mean carotid IMT values increased according to the apoA-I/C-III/A-IV SstI genotype groups in the order of S1S1 (0.58+/-0.08 mm), S1S2 (0.61+/-0.08 mm), and S2S2 (0.70+/-0.16 mm, p=0.02, ANOVA). In multiple linear regression analysis after adjusting for age, sex and body mass index the mean IMT thickness among the S2 allele carriers was higher (p=0.02) compared to non-carriers. In logistic regression analysis the frequency of S2 allele carriers was higher among the high IMT group compared to the low IMT group (OR=4.02, CI: 1.68-9.61, p=0.002). No significant association between apoB XbaI polymorphism and carotid IMT was found. However, serum total and LDL cholesterol and apoB concentrations were significantly different among apoB genotype groups (p<0.001 for all traits). The apoA-I/C-III/A-IV SstI polymorphism is associated with carotid IMT in young Finns.

Relation between XbA1 apolipoprotein B gene polymorphism and cardiovascular risk in a type 2 diabetic cohort

AIM

To evaluate in a prospective study the association of XbA1 apolipoprotein B (apoB) gene polymorphism with lipid parameters and cardiovascular (CV) events in a type 2 diabetic cohort.

METHODS AND RESULTS

A cohort of 212 type 2 diabetic patients, free of any cardiovascular complication, was studied. Cardiovascular events were registered for all the patients for 5 years. XbA1 apolipoprotein B gene polymorphism was analysed by PCR-RFLP method. A mild increase in HbA1c was found in X+X+ carriers (P = 0.014). Despite this lower glycemic control, there were no differences between genotype subgroups for lipid parameters except for apoB, significantly higher in X+X+ than in X-X- subjects. In univariate analysis, the cardiovascular events rate was higher in X-X- but did not reach statistical significance (P =0.07). In stepwise multivariate regression analysis, cardiovascular events risk was significantly higher in X- carriers (P = 0.014) and also in smokers, microalbuminuric and older patients.

CONCLUSIONS

We report for the first time in a prospective study the association of XbA1 apolipoprotein B gene polymorphism and cardiovascular events in a diabetic population. The mechanism underlying the excess of cardiovascular risk in X- carriers, despite a better metabolic profile, is likely to involve a linkage disequilibrium between apolipoprotein B gene locus and another gene locus related to cardiovascular risk.

Molecular variation at the apolipoprotein B gene locus in relation to lipids and cardiovascular disease: a systematic meta-analysis

Apolipoprotein B (apoB) is the sole protein component of low-density lipoprotein (LDL) and is thought to play an important role in atherogenesis. We performed a meta-analysis of the associations between the three most frequently investigated polymorphisms (XbaI, signal peptide insertion/deletion, EcoRI) in the apolipoprotein B (APOB) gene, lipid parameters, and the risk of ischemic heart disease (IHD). We restricted our analysis to Caucasians. Homozygotes for the XbaI X+ allele had significantly elevated levels of LDL cholesterol (LDL-C) and apoB, but a decreased risk (OR=0.80; 95%CI: 0.66-0.96) of IHD. Homozygosity for the signal peptide deletion allele was associated with similarly increased levels of LDL-C and apoB, and with an increased risk of IHD (OR=1.30; 95%CI: 1.08-1.58). Subjects homozygous for the rare EcoRI allele had significantly decreased levels of total and LDL cholesterol, but unaltered risk of IHD. We conclude that all three polymorphic apoB sites are associated with altered lipid levels, but not necessarily with a consistently altered risk of IHD. These data suggest that the relationship between apoB levels, hypercholesterolemia and IHD risk cannot have a simple molecular basis in the apoB gene.

The X-X-/E+E+ genotype of the XbaI/EcoRI polymorphisms of the apolipoprotein B gene as a marker of coronary artery disease in a Brazilian sample

Studies that consider polymorphisms within the apolipoprotein B (apo B) gene as risk factors for coronary artery disease (CAD) have reported conflicting results. The aim of the present study was to search for associations between two DNA RFLPs (XbaI and EcoRI) of the apo B gene and CAD diagnosed by angiography. In the present study we compared 116 Brazilian patients (92 men) with CAD (CAD+) to 78 control patients (26 men) without ischemia or arterial damage (CAD-). The allele frequencies at the XbaI (X) and EcoRI (E) sites did not differ between groups. The genotype distributions of CAD+ and CAD- patients were different (chi (1) = 6.27, P = 0.012) when assigned to two classes (X-X-/E+E+ and the remaining XbaI/EcoRI genotypes). Multivariate logistic regression analysis showed that individuals with the X-X-/E+E+ genotype presented a 6.1 higher chance of developing CAD than individuals with the other XbaI/EcoRI genotypes, independently of the other risk factors considered (sex, tobacco consumption, total cholesterol, hypertension, and triglycerides). We conclude that the X-X-/E+E genotype may be in linkage disequilibrium with an unknown variation in the apo B gene or with a variation in another gene that affects the risk of CAD.

An investigation of human apolipoproteins B and E polymorphisms in two African populations from Ethiopia and Benin

Three polymorphisms (XbaI, EcoRI, and Ins/Del) of the apolipoprotein B (APOB) gene and the polymorphism of apolipoprotein E (APOE) were investigated in two population samples of Amhara and Oromo origin from Ethiopia, and in two population samples of Bariba and Berba origin from Benin. No heterogeneity was observed within each major group. The cumulated frequencies of the APOB X+, R+, and D alleles for the Ethiopia and the Benin groups were 0.268 and 0.133, 0.958 and 0.818, 0.206 and 0.223, respectively. Regarding APOE, the cumulated allele frequencies of Ethiopia and Benin were 0.031 and 0.103 for epsilon*2 allele, 0.811 and 0.742 for epsilon*3, and 0.143 and 0.155 for epsilon*4, respectively. APOE typing performed at the protein level only in the Ethiopians revealed a variant allele, epsilon*5, found at the polymorphic level both in the Amhara and in the Oromo (cumulated frequency: 0.015). A tentative explanation for the higher frequencies of epsilon*4 and epsilon*5 alleles was sought in relation to the lifestyle and ethnicity of the two populations. Am. J. Hum. Biol. 11:297-304, 1999. Copyright 1999 Wiley-Liss, Inc.

Association of the apolipoprotein B gene polymorphisms with cholesterol levels and response to fluvastatin in Brazilian individuals with high risk for coronary heart disease

The influence of genetic polymorphism of the apolipoprotein B on lipid metabolism and coronary heart disease (CHD) risk has been demonstrated in different populations, but few studies have shown the contribution of this risk factor in individuals from Brazil. The Ins/del, Xbal and EcoRI polymorphisms of apo B were evaluated in 93 controls and in 104 Caucasian individuals presenting with a high risk lipid profile (HR1) for CHD; 54 of these subjects (HR2) were treated with fluvastatin during 16 weeks. DNA polymorphisms of the apo B gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism. The X(-)X(-) genotype for Xbal polymorphism was associated with higher serum concentrations of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) (p<0.01) in women of the HR1 group. The Ins/del and EcoRI polymorphisms were not associated with variation of lipid profile. After treatment with fluvastatin, TC and LDL-C levels of HR2 individuals were reduced by 23% and 30%, respectively. Individuals with II genotype had significantly greater reduction (34%) of LDL-C than those with ID/DD genotypes (27%). These results indicate that the Xbal polymorphism is associated with variation of serum TC and LDL-C levels in Brazilian women with lipid profile of risk for CHD and the Ins/del polymorphism is associated with the therapeutic response to fluvastatin.

Apolipoprotein E genotype and plasma levels in coronary artery disease. A case-control study in the Italian population

OBJECTIVES

To investigate the role of the apolipoprotein B and apolipoprotein E polymorphisms in coronary artery disease (CAD) susceptibility in the Italian population and their relation to plasma lipid and apolipoprotein levels.

METHODS

APOB (APOB Xbal, EcoRI, Ins/Del), and APOE (APOE Cfol) polymorphisms were analyzed in 150 male CAD patients and 110 matched controls. In the same subjects plasma lipid, apoB, and apoE levels were measured.

RESULTS

No differences in the distribution of the APOB polymorphisms were observed between patients and controls. Among patients the number of e*4-carriers was significantly higher than in controls. e*4-carriers were more frequent among the hypertensive patients and had a higher systolic blood pressure (p = 0.007) than the non-e*4 carriers. The APOB Xbal polymorphism was found to influence the distribution of HDL-cholesterol. Patients showed significantly lower levels of apoE (39.29 mg/L) than controls (54.32 mg/dL) and the lowest concentrations were associated to the E4/E3 and E4/E4 genotypes.

CONCLUSION

Quantitative data are consistent with the hypothesis that apoE has an anti-atherosclerotic role and suggest that the apoE quantitation could be a useful parameter for defining cardiovascular risk. e*4 allele appears to be a risk factor for CAD in the Italian population and could act by its association with low apoE levels.

Molecular genetics of congestive heart failure

The manifestation of congestive heart failure occurs secondary to a great variety of cardiac or systemic disorders that share a temporal or permanent loss of cardiac function. In order to enhance our knowledge about the genetics of heart failure it is mandatory to analyse the aetiologic factors of these underlying disorders separately. Monogenic forms of congestive heart failure have initially been described by observant physicians in consecutive generations of affected families. Molecular genetic analyses of these families subsequently allowed us to localise and identify some of the genes that cause hypertrophic, dilative, or restrictive cardiomyopathies, congenital heart disease, as well as a number of inborn errors of metabolism. However, the great majority of patients develops heart failure as a final consequence of multifactorial conditions such as hypertension, cardiac hypertrophy, or coronary artery disease. Each of these conditions may be the product of a complex equation that includes environmental and genetic factors. Indeed, some of these factors may be harmful, others protective and for most it takes decades before a phenotype will be clinically detectable. Given this complex scenario it was not unexpected that early studies on candidate genes came up with partially controversial information. This review aims to summarize and to comment on the principal findings of this work.

Apolipoproteins B and E, and angiotensin I-converting enzyme (ACE) genetic polymorphisms in Italian women with coronary artery disease (CAD) and their relationships with plasma lipid and apolipoprotein levels

The XbaI, EcoRI and the signal peptide insertion/deletion (I/D) polymorphic sites of APOB gene, the CfoI polymorphic site of apolipoprotein E gene (APOE), and the insertion/deletion polymorphism of angiotensin I-converting enzyme (ACE) gene were studied using polymerase chain reaction (PCR) in 55 postmenopausal women with coronary artery disease (CAD) and in 119 control women of equivalent age. Patients and controls were recruited from the population of Rome, considered representative of Central and Southern Italy. There were no significant differences in allele frequencies between the two groups, though APOB X-, R- and I, APOE*3, and ACE D alleles were slightly more frequent in the cases than in the controls. The patients did not differ from the controls for plasma total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, and apoAI values, while they presented significantly higher levels of triglycerides and apoB, and lower apoE levels. TC, apoE, and apoB quantitative values, adjusted for age, varied significantly among APOB XbaI and APOE genotypes. APOB X-X- genotype was associated in patients with a significantly lower mean TC concentration than the other two genotypes pooled together. APOE 3-2 genotype in the controls had significantly lower TC levels with respect to the other two pooled genotypic classes and higher apoE levels compared to 3-3 and 4-3 genotypes. In the patients, 3-2 genotype had significantly lower apoB levels than the pooled 3-3 and 4-3 class. We conclude that in the Italian women the DNA polymorphisms studied in this work do not seem to be important risk factors for CAD occurrence; that apoE quantitation could be another useful parameter to identify subjects at risk of CAD; and that APOB X- and APOE*2 are the alleles that most influence the interindividual plasma lipid variation among CAD female patients.

Polymorphism of the apolipoprotein B gene and blood lipid concentrations in Japanese and Caucasian population samples

To examine whether a racial difference in apolipoprotein B (Apo B) gene polymorphism between Japanese and American Caucasians corresponds with the lower blood cholesterol concentrations in Japanese than in Americans, we examined the EcoRI polymorphism of the Apo B gene for 271 nonsmoking men and women aged 47-69 years in two population-based samples: rural Japanese living in Akita and Caucasians living in Minneapolis-St. Paul, Minnesota, USA. Mean values of serum cholesterol concentrations were significantly lower in Japanese than in Caucasians for both men and women (difference = 25-26 mg/dl). An allele-specific polymerase chain reaction was conducted to examine the Eco RI cutting site at the 12669 cDNA position of the Apo B gene. The allele R2 (absence of the cutting site) has been associated with lower cholesterol concentrations in two previous studies. The frequency of the R2 allele was 6% for Japanese and 17% for Caucasians (P < 0.001), and this race difference in allele frequency was identical for men and women. After controlling for age, body mass index, alcohol intake, and for women, menopausal status and hormone replacement therapy, the adjusted mean (SE) cholesterol level among Japanese was 204 (3) mg/dl for genotype R1R1 and 185 (7) mg/dl for genotype R1R2 or R2R2 combined (P = 0.01). The respective mean values among Caucasians were 224(5) mg/dl and 232(7) mg/dl (P = 0.36). The polymorphism had a similar effect on total cholesterol concentrations for both men and women. The observed lower prevalence of the R2 allele in Japanese than in Caucasians indicates that this variation in the Apo B gene does not explain the racial difference in blood cholesterol concentrations.

Association of polymorphisms of the apolipoprotein B gene with coronary heart disease in Han Chinese

Four polymorphic sites of the apolipoprotein B (apo B) gene were investigated by using polymerase chain reaction (PCR) in 103 patients with coronary heart disease (CHD) and 100 age-matched healthy individuals selected from a population of Han Chinese in the Beijing area. The rare X+ allele of the XbaI restriction site was more frequently seen in CHD patients than in controls (0.088 vs. 0.025, P < 0.01). The relative frequency of rare E- allele of the EcoRI restriction site was significantly higher in CHD patients compared with controls (0.11 vs. 0.04, P < 0.01). Similarly, 3'VNTR-L allele (number of repeat units > 39) at the VNTR region was also present at an apparently high frequency in CHD patients in comparison to that in controls (0.602 vs. 0.290, P < 0.001). However, the difference in relative frequency of rare Del allele of the Ins/Del polymorphism at the signal peptide was not significant between the two groups (0.282 vs. 0.235. P > 0.05). In comparison with Caucasians, the relative frequencies of rare alleles (Del, X+ and E-) were found to be statistically lower in Han Chinese. Furthermore, the Del and X+ alleles, in linkage disequilibrium, were associated with significantly lower plasma level of HDL-C in CHD patients. Therefore it is suggested that genetic variation with the apo B gene may exert some impact on lipid metabolism and contribute to the susceptibility to development of CHD in Han Chinese.