Apolipoprotein E genotypes predict attendance rates at lipid clinic

Except for the rare epsilon 22 genotype it remains largely unsettled whethe r apolipoprotein E genotype influences an individual's referral to lipid cl inics. To test this hypothesis, we compared genotype distributions among 15 6 hypercholesterolemic and 83 hypertriglyceridemic patients attending a lip id clinic with that among 9241 individuals sampled from the Danish general population. The relative genotype frequencies of epsilon 22, epsilon 32, ep silon 42, epsilon 33, epsilon 43, and epsilon 44 were 0.005, 0.126, 0.026, 0.564, 0.251, and 0.027 in the general population, which differed from geno type frequencies in both hypercholesterolemic (chi (2): P = 0.01) and hyper triglyceridemic patients (chi (2): p < 0.001). BY comparison with <epsilon> 33, epsilon 44 predicted a 2-fold increase whereas epsilon 32 predicted a 2 -fold decrease in the attendance rate at the lipid clinic for hypercholeste rolemic patients (95% confidence intervals: 1.1-4.3 and 0.2-0.9). Among hyp ertriglyceridemic patients, epsilon 22, epsilon 42, epsilon 43, and epsilon 44 versus epsilon 33 predicted 13-, 3-, 11/2-, and 3-fold attendance rates at the lipid clinic, respectively (95% confidence intervals: 4.5-39.9, 1.2 -8.4, 1.0-2.8, and 1.1-7.6). These findings are in accordance with the fact that epsilon 44 raises cholesterol levels, epsilon 32 reduces cholesterol levels, and epsilon 22, epsilon 42, epsilon 43, and epsilon 44 raise trigly ceride levels in comparison with epsilon 33. These data suggest that hyperc holesterolemic individuals carrying epsilon 44 and hypertriglyceridemic ind ividuals carrying epsilon 22, epsilon 42, epsilon 43, or epsilon 44 are rel atively more often referred to lipid clinics than carriers of epsilon 33. ( C) 2000 Elsevier Science Ireland Ltd. All rights reserved.