Abstract
BackgroundChronic kidney disease (CKD) associates with complex lipoprotein disturbances resulting in high cardiovascular risk. Apolipoprotein E (APOE) is a polymorphic protein with three common isoforms (E2; E3; E4) that plays a crucial role in lipoprotein metabolism, including hepatic clearance of chylomicrons and very low-density lipoprotein (VLDL) remnants, and reverse cholesterol transport. It demonstrates anti-atherogenic properties but data concerning the link between polymorphism and level of APOE in CKD patients are inconclusive.The aim of our research was to assess the relationship between APOE gene polymorphism and APOE concentration and its redistribution among lipoproteins along with CKD progression.Methods90 non-dialysed CKD patients were included into the study. Real time PCR was used for APOE genotyping. APOE level was measured in serum and in isolated lipoprotein fractions (VLDL; IDL + HDL; HDL). Kidney function was assessed using eGFR CKD-EPI formula.ResultsThe population was divided into three APOE genotype subgroups: E2(ε2ε3), E3(ε3ε3) and E4(ε3ε4). The highest APOE level was observed for the E2 subgroup (p < 0.001). APOE concentration positively correlated with eGFR value in the E2 subgroup (r = 0.7, p < 0.001) but inversely in the E3 subgroup (r = − 0.29, p = 0.02).). A lower concentration of APOE in the E2 subgroup was associated with its diminished contents in HDL and IDL + LDL particles. In the E3 subgroup, the higher concentration of APOE was related to the increased number of non-HDL lipoproteins.ConclusionIn patients with CKD, APOE genotype as well as renal function are associated with the concentration of APOE and its redistribution among lipoprotein classes.
Highlights
Chronic kidney disease (CKD) associates with complex lipoprotein disturbances resulting in high cardiovascular risk
The analyzed subgroups did not differ in their age, sex, body mass index (BMI) index, status of smoking cigarettes, statin treatment, as well as kidney function measured by estimated glomerular filtration rate (eGFR) chronic kidney disease epidemiology collaboration (CKD-EPI) value (Table 1)
There were no significant differences in a basic lipid profile parameters as well as apolipoprotein B (APOB) and APOAI levels between the Apolipoprotein E (APOE) subgroups (Table 2)
Summary
Chronic kidney disease (CKD) associates with complex lipoprotein disturbances resulting in high cardiovascular risk. Apolipoprotein E (APOE) is a polymorphic protein with three common isoforms (E2; E3; E4) that plays a crucial role in lipoprotein metabolism, including hepatic clearance of chylomicrons and very low-density lipoprotein (VLDL) remnants, and reverse cholesterol transport. It demonstrates anti-atherogenic properties but data concerning the link between polymorphism and level of APOE in CKD patients are inconclusive. Apolipoprotein E (APOE), a 34 kDa glycoprotein, is produced mainly in the liver but its local production has been documented in the brain, kidneys, spleen, adrenals and macrophages [9] It is a component of all classes of lipoproteins except small dense LDL. It was shown that cholesterol-loaded macrophages demonstrated higher APOE gene expression; APOE deficiency in these cells decreased cholesterol efflux and led to atherosclerosis plaques formation [15]
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