APOE polymorphism and the hypertriglyceridemic effect of dietary sucrose

Background: The E4 allele of the apolipoprotein gene (APOE) is associated w ith a greater serum cholesterol response to dietary changes in fat and chol esterol. However, less is known about the interaction between APOE polymorp hism and other macronutrients in the diet. Objective: We evaluated the interaction between APOE polymorphism and dieta ry fat and carbohydrate, particularly sucrose, in relation to serum lipid c oncentrations. Design: A total of 284 men and 130 women with coronary artery disease (mean age: 61 y; range: 33-74 y) participated in the cross-sectional EUROASPIRE study. Serum lipids and fatty acids in cholesteryl esters (CEs) were measur ed and APOE genotypes were determined. Dietary intake was examined by using a 4-d food record. Results: Patients were grouped by APOE genotype: E2 (E2/E2 and E2/E3; n = 2 1), E3 (E3/E3; n = 245), and E4 (E4/E2, E4/E3, and E4/E4; n = 148). Patient s with the E2 allele had lower LDL-cholesterol concentrations and tended to have higher triacylglycerol concentrations than did patients with the E3 o r E4 allele; concentrations were not significantly different between the la st 2 groups. In regression analysis, significant predictors of serum triacy lglycerol were the interaction between sucrose intake and the E2 allele, pr oportion of n-3 fatty acids in CEs, body mass index, and diabetes. A high s ucrose intake was associated with high triacylglycerol concentrations only in patients with the E2 allele. Interaction between saturated fat intake an d the E2 allele, proportion of linoleic acid in CEs, and fiber intake predi cted serum cholesterol. Conclusion: Coronary artery disease patients with the E2 allele will likely have a greater triacylglycerol response to high dietary sucrose intakes th an will patients with the E3 or E4 allele.