750-5 Apolipoprotein E Alleles, Dyslipidemia, and Coronary Heart Disease: The Framingham Offspring Study

Abstract

The association between Apolipoprotein E (apo E) alleles (ε2, ε3 and ε4), dyslipidemias, and coronary heart disease (CHD) prevalence was studied in a community-based sample of middle-aged men (n = 1034) and women (n = 916) aged 40–77 years, participating in a long term study of cardiovascular disease. Compared with the 83 allele, the, 4 allele was associated with elevated LDL–C (≥4.14 mmol/L [160 mg/dL]) in women, the ε2 and ε4 alleles were associated with moderately elevated triglycerides (≥2.82 mmol/L [250 mg/dL]) in men, and the ε2 allele was associated with severely elevated triglycerides (>5.64 mmollL [500 mg/dL]) in men. The apo E alleles were not associated with hypertension, obesity, smoking, or diabetes, but the ε4 allele frequency was reduced in women after age 60 years. The age-adjusted prevalence of CHD was associated with the ε4 allele in men (relative odds = 1.53, P = 0.037) and women (relative odds = 1.99, P = 0.049). In analyses for women and for both sexes combined this relation persisted after adjustment by hypertension, smoking, obesity, diabetes, HDL–C, and LDL–C. Apo E alleles are important genetic markers for dyslipidemia and CHD. The estimated CHD odds associated with the ε4 allele appears to be greater than that for any other known genetic lipid abnormality, and the ε4 allele association with CHD remains significant in women and both sexes combined after adjustment by traditional coronary risk factors and lipids.