Abstract
BackgroundIn population-based studies, the genetic variability of the APOE E alleles have been associated with health outcomes. Health problems are common in subjects with obesity. This study explored associations between the APOE E alleles and comorbidity in subjects with morbid obesity.MethodsThe study included consecutive subjects referred for evaluation of bariatric surgery with morbid obesity (defined as BMI > 40 or > 35 kg/m2 with complications related to obesity). The subjects followed a conservative weight loss program for 6 months before surgery and had a follow-up visit 12 months after surgery. Demographic data and a set psychosomatic scores (musculoskeletal pain, WHO-5 Well-Being Index, Rosenberg Self-Esteem Scale, Hopkins Symptom Check-list 10; Epworth Sleepiness Scale, and Fatigue Severity Scale) were collected, and blood samples were analysed for haematological and biochemical parameters and APOE alleles.ResultsOne hundred and forty subjects (men/women: 32 (23%)/108 (77%) with mean age 43.0 (SD 8.7) years and BMI 42.1 (SD 3.8) kg/m2 were included. One hundred and eight and 92 subjects had data after conservative treatment and 12 months after surgery, respectively. The prevalence of the APOE alleles were: E2E2: 1 (0.7%), E2E3: 13 (9.3%), E2E4: 4 (2.9%), E3E3: 71 (50.7%), E3E4: 47 (33.6%), and E4E4: 4 (2.9%). The prevalence rates were as anticipated in a Norwegian population. The weight loss during conservative treatment and after bariatric surgery was independent of E allele variability. E2 was associated with a significant or clear trend toward improvement of all psychosomatic disorders. There was a significant fall in CRP during the two treatment periods with weight loss. E2 and E4 were significantly associated with high and low CRP, respectively, but no associations were seen between CRP and comorbidity.ConclusionsThe most marked finding was the association between E2 and improvement of all psychosomatic disorders. The positive and negative associations between CRP and E2 and E4, respectively, could indicate effects on inflammation and immunological reactions.
Highlights
In population-based studies, the genetic variability of the APOE E alleles have been associated with health outcomes
Three hundred and fifty Caucasian subjects with morbid obesity were referred to the obesity unit during the inclusion period
The most important finding was the marked improvement of all psychosomatic disorders related to the presence of the E2 allele in subjects with morbid obesity
Summary
In population-based studies, the genetic variability of the APOE E alleles have been associated with health outcomes. This study explored associations between the APOE E alleles and comorbidity in subjects with morbid obesity. Depending on the genetic variability, the gene has been ascribed significant positive and negative health effects such as longevity and shortened lifespan, neurological and psychosomatic disorders, cognitive decline and Alzheimer disease, altered lipoprotein profile, atherosclerosis and cardiovascular disease, type II diabetes, changes in the immune response, oxidative stress, quality of life, physical activity, and obesity [1,2,3,4]. The associations between biomarkers and disease in subjects with obesity are, not always as expected, as exemplified by the protective effect of obesity on the outcome of cardiovascular disease (the obesity paradox) [15]. Except for a possible association between E4 and obesity, little is known about associations between APOE variability and morbidity in subjects with obesity [2, 3]
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