INTERACTIONS BETWEEN LIFE-STYLE-RELATED FACTORS AND THE APOE POLYMORPHISM ON PLASMA-LIPIDS AND APOLIPOPROTEINS - THE EARS STUDY

To elucidate how the apolipoprotein (apo) E polymorphism and modifiabl e factors interact in explaining plasma lipid and apolipoprotein level s, we studied 1448 young adults (18 to 26 years old), participating in the European Atherosclerosis Research Study (EARS). Venous blood was collected after an overnight fast. Modifiable factors, eg, body mass i ndex (BMI), waist-to-hip ratio (WHR), tobacco and alcohol consumption, and physical activity, were determined by using standardized protocol s. Associations of modifiable factors with apoE levels were homogeneou s across apoE phenotypes. In contrast, correlations of BMI with total cholesterol and apoB levels, as well as correlations between WHR and a poB, were significantly (P<.05 to P<.01) stronger in E2 carriers than in subjects with other phenotypes. Total cholesterol and apoB levels w ere comparable in E2 carriers in the upper tertile of BMI or WHR to th ose in E3/3 subjects, suggesting that the lowering effect of the E2 al lele was no longer present. The inverse association between the plasma cholesteryl linoleate-to-oleate ratio, a marker for the dietary polyu nsaturated-to-saturated fatty acid ratio, and triglycerides was also s tronger in E2 carriers (-0.33 versus -0.17 in E3/3 and -0.24 in E4 car riers). Associations with other modifiable factors were notably consis tent across apoE phenotypes. Gender and modifiable factors explained t hree times more (31%) of the interindividual variation in apoB levels in E2 carriers than in E3/3 subjects (9%) or E4 carriers (14%), mainly due to a larger variance explained by BMT. Our results suggest that t he apoE polymorphism acts in a relatively uniform manner, independentl y of lifestyle. However, the associations of adiposity to total choles terol and apoB levels appear to be stronger in apoE2 carriers.