THE RELATION OF APOLIPOPROTEIN-E POLYMORPHISM TO MULTIPLE CARDIOVASCULAR RISK IN CHILDREN - THE BOGALUSA HEART-STUDY

Apolipoprotein (apo) E is an important genetic determinant of serum li poprotein concentrations and coronary artery disease risk. Multiple ca rdiovascular risk factors in addition to lipoproteins were examined by apoE phenotype in a random subsample (n = 746) of 8-17-year old child ren from a total community. The apoE2 group (n = 58) carrying E2/2 and E3/2 phenotypes showed lower age-, race- and sex-adjusted mean values of body mass index (BMI: weight/height(2)), percent body fat, fasting plasma insulin and LDL cholesterol, and a higher value of HDL cholest erol than the apoE3 group (n = 476) carrying the E3/3 phenotype (P < 0 .01). In contrast, the apoE4 group (n = 212) carrying E4/4 and E3/4 ph enotypes displayed higher values of total cholesterol and LDL choleste rol (P < 0.01). Both insulin and BMI, which correlated with each other , showed an association to triglycerides and systolic blood pressure i n all three phenotype groups; whereas only BMI associated with LDL cho lesterol, total cholesterol to HDL cholesterol ratio and diastolic blo od pressure in all three phenotype groups (P < 0.05 to P < 0.0001). A marked increase in the prevalence of clustering of adverse (top tertil e) total cholesterol to HDL cholesterol ratio with increased levels (t op tertile) of one or two risk factors (BMI, insulin, and systolic blo od pressure) occurred in the apoE3 and apoE4 groups, especially in the latter (P < 0.01 to P < 0.0001), but not in the apoE2 group. The prev alence of parental history of heart attack and diabetes mellitus among the three phenotype groups paralleled this trend. Thus, the risk stat us of apoE polymorphism may be associated with a constellation of card iovascular risk factors in early life.