Influence of variation at the apolipoprotein E locus on lipid and lipoprotein levels in CAPD patients

Background. Variation at the apolipoprotein E (apo E)locus influence lipid and lipoprotein levels in the normal population, andis associated with premature coronary artery disease. Patients withend-stage kidney disease or undergoing dialysis treatment are particularlyprone to develop accelerated atherosclerosis. Methods.To evaluate the influence of genetic variation at the apo E locus, apo Egenotypes and serum lipid and lipoprotein levels were measured in 51subjects undergoing continuous ambulatory peritoneal dialysis (CAPD).Results. The distribution of apo E phenotypes and apoE allelic frequency among the CAPD subjects (&egr;2 0.049; &egr;30.745; &egr;4 0.206) corresponded to the healthy Swedish population. Inthe CAPD subjects, total serum and LDL cholesterol levels were high(6.7±1.5 mmol/l and 4.2±1.3 mmol/l respectively) andHDL cholesterol levels were low (1.2±0.5 mmol/l). When directlycomparing the two major apo E groups, E 3/3 subjects (n=30) and E4/3 and4/4 subjects, &egr;4-carriers, (n=16), LDL cholesterol levels weresignificantly higher among &egr;4-carriers (4,8±1.1 vs4.0±1.2 mmol/l, P<0.03), but total serum cholesterollevels was not higher among the &egr;4-carriers (7.3±1.3 vs6.5±1.5 mmol/l, P<0.08). Serum triglycerides or HDLcholesterol levels did not differ significantly between&agr;3-homozygotes and &egr;4-carriers.Conclusions. The results demonstrate a strong effectof variation of the apo E locus on LDL cholesterol levels in CAPD subjects,suggesting that &egr;4-carriers may be more susceptible to accelerateddevelopment of atherosclerosis in this condition.