POLYMORPHISMS OF THE APOLIPOPROTEIN AND ANGIOTENSIN-CONVERTING ENZYMEGENES IN YOUNG NORTH KARELIAN PATIENTS WITH CORONARY HEART-DISEASE

The genes encoding apolipoproteins (apos) A-I, B, C-III and E as well as that encoding the angiotensin converting enyzme (ACE) have been pro posed as candidate genes for coronary heart disease (CHD). We deter mi ned the common polymorphisms of the apo genes, previously found to inf luence serum lipid levels at the population level, and the insertion/d eletion polymorphism of the ACE gene, recently reported to reflect the risk of myocardial infarction, in 82 very young (mean, 41 years) Nort h Karelian Finns with symptomatic CHD and 50 controls of similar age. Patients with familial hypercholesterolemia had been excluded from thi s material. None of the polymorphisms examined, including the ape A-I promoter MspI, apo C-III SstI and apo B XbaI restriction fragment poly morphisms, a common variation of apo E (epsilon 2, epsilon 3 and epsil on 4 alleles) and an ACE insertion/deletion (I/D) polymorphism, was si gnificantly associated with the risk of premature CHD. Patients with C HD had a higher mean serum LDL cholesterol/HDL cholesterol ratio than controls (3.15 +/- 1.30 vs 2.72 +/- 0.98, P < 0.05), but no significan t associations between the common apo gene polymorphisms and serum lip id levels were disclosed in either group. It is possible that other ge netic loci than those proposed to be associated with accelerated ather osclerosis may be more important as risk factors of symptomatic CHD at the age of 40 years.