载脂蛋白E基因多态性对血脂的影响

目的 探讨载脂蛋白E(ApoE)基因多态性对血脂水平的影响。方法 1452例受试者，其中心脑血管疾病患者1101例(脑梗死379例、脑出血313例、冠心病257例、其他类型152例)及对照组351例。采用聚合酶链反应-限制性片段多态性方法检测ApoF基因多态性。结果 调整年龄、性别和体重指数，ApoE4携带者的血清总胆固醇(TC)、低密度脂蛋白胆固醇和ApoB水平显著高于ApoE3／3和ApoE2携带者(P＜0．05)，这种作用在不同性别和不同年龄段中相似；ApoE4携带者的甘油三酯(TG)水平和E3／3型差异有统计学意义(P＜0．05)，ApoE2携带者的高密度脂蛋白胆固醇(HDL-C)水平显著高于ApoE4携带者(P＜0．05)。ApoE2携带者的HDL-C水平随年龄增大而升高(β=0．178，P=0．015)，且在65～74岁年龄段中HDL-C水平明显高于E3／3和E4携带者(P＜0．05)；ApoE4携带者的TC和TG水平随年龄增大而下降(β=-0．179，P=0．009；β=-0．147，P=0．032)。结论 ApoE基因多态性影响血脂的代谢水平，这种作用在不同性别和年龄段存在；ApoE2和ApoE4携带者对血脂的作用程度与年龄相关。

The relationship between ApoE gene polymorphism and lipid parameters

OBJECTIVE: To investigate the relationship between apolipoprotein E (ApoE) gene polymorphism and serum lipid profile. METHODS: Polymerase chain reaction-restricted fragments length polymorphism (PCR-RFLP) was used to determine ApoE genotype on 1452 subjects including 1101 cases with cardio cerebrovascular disease including 379 cases with cerebral infarction, 313 cases with cerebral hemorrhage, 257 cases with coronary heart disease, and 152 cases with other types and on 351 healthy controls. RESULTS: After adjusting for age, sex and BMI, the subjects with ApoE4 carriers had significantly higher levels of total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and ApoB than those with ApoE2 carriers and ApoE3/3 (P < 0.05), and higher level of triglyceride(TG) than those with ApoE3/3 (P < 0.05), while the subjects with ApoE2 carriers had significantly higher levels of high density lipoprotein-cholesterol (HDL-C) than those with ApoE4 (P < 0.05). The effects of ApoE polymorphism exhibited similarity in different sex and age of subjects. Linear regression analysis showed that unlike ApoE3/3, the HDL-C level in ApoE2 carriers tend upward with age (beta = 0.178, P = 0.015), significantly higher than ApoE4 carriers and ApoE3/3 in the cohort of 65-74 years (P < 0.05). The level of TC and TG in ApoE4 carriers had a tendency of downward with age (p = -0.179, P = 0.009; beta = -0.147, P = 0.032). CONCLUSION: ApoE gene polymorphism affected profile of blood lipids and the effects were found in different sex and age. The degrees of effects related to ApoE2 carriers and ApoE4 carriers to blood lipid level seemed to be related to age.