Abstract

AimTo analyze apolipoprotein gene polymorphisms in the Tunisian population and to check the relation of these polymorphisms and homocysteine, lipid and apolipoprotein levels to the coronary artery disease (CAD).MethodsIn healthy blood donors and in patients with CAD complicated by myocardial infarction (MI) four apolipoprotein gene polymorphisms [APO (a) PNR, APO E, APO CI and APO CII] were determined and plasma levels of total homocysteine, total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HLD-C) and apolipoproteins (apo A-I, Apo B, Apo E) were measured.ResultsAnalysis of the four apolipoprotein gene polymorphisms shows a relative genetic homogeneity between Tunisian population and those on the other side of Mediterranean basin. Compared to controls, CAD patients have significantly higher main concentrations of TC, TG, LDL-C, apo B and homocysteine, and significantly lower ones of HDL-C, apo A-I and apo E. The four apolipoprotein gene polymorphisms have not showed any significant differences between patients and controls. However, the APO E4 allele appears to be associated to the severity of CAD and to high levels of atherogenic parameters and low level of apo E, which has very likely an anti-atherogenic role.ConclusionAlthough APO (a) PNR, APO CI and APO CII genes are analyzed in only few populations, they show a frequency distribution, which is not at variance with that of APO E gene and other widely studied genetic markers. In the Tunisian population the APO E 4 appears to be only indirectly involved in the severity of CAD. In the routine practice, in addition of classic parameters, it will be useful to measure the concentration of apo E and that of Homocysteine and if possible to determine the APO E gene polymorphism.

Highlights

  • Coronary artery disease (CAD) is a multifactorial disease caused by genetic and environmental factors

  • Apolipoprotein genes involved in lipoprotein synthesis and metabolism are considered excellent candidates for studying the susceptibility to CAD and myocardial infarction (MI) [1]

  • Functional variants of genes encoding lipoproteins are responsible in part for between-individual variation in the plasma levels of lipoproteins and, they are related with the risk for atherosclerosis [2]

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Summary

Introduction

Coronary artery disease (CAD) is a multifactorial disease caused by genetic and environmental factors. Apolipoprotein genes involved in lipoprotein synthesis and metabolism are considered excellent candidates for studying the susceptibility to CAD and myocardial infarction (MI) [1]. Apolipoprotein (a) is a highly glycosylated protein component of lipoprotein (a) [3]. It is a highly polymorphic protein whose size varies depending on the number of Kringle IV type 2 (KIV) repeats [4]. Inconsistent results have been published concerning association of this polymorphism with CAD and/or MI [7,8]

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