LIPID PROFILES REFLECTING HIGH AND LOW-RISK FOR CORONARY HEART-DISEASE - CONTRIBUTION OF APOLIPOPROTEIN-E POLYMORPHISM AND LIFE-STYLE

To elucidate the role of modifiable factors and the apolipoprotein E p olymorphism in explaining lipid profiles reflecting low, average and h igh risk for coronary heart disease, we selected subjects from a large population-based study. Subjects with low total cholesterol (TC) (< 1 5th percentile) and high HDL-cholesterol levels (> 85th percentile) we re randomly selected (n = 99) and represent subjects with a low risk l ipid profile. Additionally, 95 subjects with total and HDL-cholesterol levels in the 15% around the population-median (median risk lipid pro file) and 100 subjects with high TC (> 85th percentile) and low HDL-ch olesterol levels (< 15th percentile) (high risk lipid profile) were se lected. Compared with E3/3 subjects, the likelihood for a low risk lip id profile was considerably higher (odds ratio 14.3; 2.6-79) in female , but not in male E2-carriers (1.5; 0.3-6.7). Smoking and alcohol cons umption were independently associated with a low risk lipid profile in both genders, physical inactivity only in women. The odds ratio for a high risk lipid profile was elevated in male E4-carriers (4.9; 1.1-23 ) only. In addition to the E4 isoform, smoking and physical inactivity , overweight was the main determinant for a high risk lipid profile (o dds ratio 16.8; 3.4-82). Male overweight E4-carriers had a 50 times hi gher likelihood of a high risk lipid profile than E3/3 men of normal w eight. In women, only overweight was independently associated with a h igh risk lipid profile. Our results suggest that both modifiable facto rs and the apolipoprotein E polymorphism contribute to a lipid profile , reflecting low, average and high risk for coronary heart disease, bu t effects may be gender-specific. (C) 1998 Elsevier Science Ireland Lt d.