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O'Donoghue MC, Murphy SE, Zamboni G, Nobre AC, Mackay CE. APOE genotype and cognition in healthy individuals at risk of Alzheimer's disease: A review. Cortex 2018; 104:103-123. [DOI: 10.1016/j.cortex.2018.03.025] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/02/2018] [Accepted: 03/19/2018] [Indexed: 01/22/2023]
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Corella D, Ordovás JM. Aging and cardiovascular diseases: the role of gene-diet interactions. Ageing Res Rev 2014; 18:53-73. [PMID: 25159268 DOI: 10.1016/j.arr.2014.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/15/2014] [Accepted: 08/18/2014] [Indexed: 12/21/2022]
Abstract
In the study of longevity, increasing importance is being placed on the concept of healthy aging rather than considering the total number of years lived. Although the concept of healthy lifespan needs to be defined better, we know that cardiovascular diseases (CVDs) are the main age-related diseases. Thus, controlling risk factors will contribute to reducing their incidence, leading to healthy lifespan. CVDs are complex diseases influenced by numerous genetic and environmental factors. Numerous gene variants that are associated with a greater or lesser risk of the different types of CVD and of intermediate phenotypes (i.e., hypercholesterolemia, hypertension, diabetes) have been successfully identified. However, despite the close link between aging and CVD, studies analyzing the genes related to human longevity have not obtained consistent results and there has been little coincidence in the genes identified in both fields. The APOE gene stands out as an exception, given that it has been identified as being relevant in CVD and longevity. This review analyzes the genomic and epigenomic factors that may contribute to this, ranging from identifying longevity genes in model organisms to the importance of gene-diet interactions (outstanding among which is the case of the TCF7L2 gene).
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Berkinbayev S, Rysuly M, Mussayev A, Blum K, Baitasova N, Mussagaliyeva A, Dzhunusbekova G, Makhatov B, Mussayev AA, Yeshmanova A, Lesbekova R, Marchuk Y, Azhibekova R, Oscar-Berman M, Kulmaganbetov M. Apolipoprotein Gene Polymorphisms (APOB, APOC111, APOE) in the Development of Coronary Heart Disease in Ethnic Groups of Kazakhstan. JOURNAL OF GENETIC SYNDROMES & GENE THERAPY 2014; 5:216. [PMID: 24772377 PMCID: PMC3998840 DOI: 10.4172/2157-7412.100021610.4172/2157-7412.1000216] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND Previous Analysis of polymorphism of genes associated with the development of coronary heart disease (CHD) reveals that the frequency distribution of genotypes and alleles depends on the ethnic characteristics of the populations under study. Further impetus is derived from the well -established links between alcoholism (high prevalence in Kazakhstan region) and cardiovascular disorders. OBJECTIVES The purpose of this study was to examine a number of apolipoprotein gene polymorphisms and correlate these alleles with changes of lipid profile in CHD patients of Kazakh and Uyghur nationalities. METHODS Four-Hundred Forty Eight (448) males of Kazakh and Uyghur nationalities residing in Kazakhstan were evaluated and genotyped. The age range of these subjects was 30-55 years which included both afflicted and controls. Specifically, 161- Kazakhs suffered from myocardial infarction compared to 112 health controls; 80- Uyghurs suffered from CHD compared to 95 health controls. Blood lipid profiles were examined in the total cohort. Genotyping was performed by polymerase chain reaction (PCR) using oligonucleotide primers identifying; ApoB; ApoC111; and APOE gene polymorphisms. RESULTS Initial screening revealed a significant inter-ethnic difference on the frequency of alleles associated with both the ApoB and APOE genes. We found that the X1 ApoB gene polymorphism is overrepresented in healthy Kazakhs relative to Uyghurs [86.4% in Kazakhs vs. 69.4% in Uyghurs]. Moreover, we found that the E4APOE allele was also overrepresented in healthy Kazakhs relative to Uyghurs [16.8% in Kazakhs vs. 9.5% in Uyghurs]. There was a significant relationship of polymorphisms of APOE such as ApoB and ApoC 111 with the value of lipid indices in Kazakhs. Additionally, we found that the E4 allele of the APOE gene also correlated with the value of lipid indices in Kazakhs. Further evaluation showed that the X2 allele of the ApoB and the S2 allele of the ApoCIII gene significantly associated with the lipid indices of Uyghurs. CONCLUSION This systematic investigation confirms the association of various alleles of Apolipoprotein gene polymorphisms and contribution to aberrant lipid metabolism. Putatively at least in our population we are proposing that certain gene polymorphisms of Apolipoprotein genes such as ApoB; ApoC111; APOE ; X2 of ApoB; and S2 of ApoCIII differentially represented in either Kazakhs or Uyghurs are genetic markers of hypertriglyceridemia.
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Affiliation(s)
- S Berkinbayev
- Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - M Rysuly
- Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - A Mussayev
- Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
| | - K Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Fl., USA
- Dominion Diagnostics, LLC., North Kingstown, Rhode Island, USA
| | - N Baitasova
- Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - A Mussagaliyeva
- Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - G Dzhunusbekova
- Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - B Makhatov
- Department of Physiology KazNAU, Almaty, Kazakhstan
| | - AA Mussayev
- National Research Cardiac Surgery Center, Department of interventional cardiology, Astana, Kazakhstan
| | - A Yeshmanova
- Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
| | - R Lesbekova
- Department of Physiology KazNAU, Almaty, Kazakhstan
| | - Y Marchuk
- Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - R Azhibekova
- Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
| | - M Oscar-Berman
- Department of Psychiatry Anatomy and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | - M Kulmaganbetov
- Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
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Tyynelä P, Goebeler S, Ilveskoski E, Mikkelsson J, Perola M, Lehtimäki T, Karhunen PJ. Age-dependent interaction of apolipoprotein E gene with eastern birthplace in Finland affects severity of coronary atherosclerosis and risk of fatal myocardial infarction--Helsinki Sudden Death Study. Ann Med 2013; 45:213-9. [PMID: 23110590 DOI: 10.3109/07853890.2012.727021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mortality from coronary heart disease (CHD) has been constantly higher in eastern late settlement regions compared to western early settlements in Finland, unrelated to classical risk factors. In line with this, eastern birthplace was an age-dependent predictor of severe coronary atherosclerosis and pre-hospital sudden coronary death among male residents of Helsinki. We investigated a possible interaction of apolipoprotein E (APOE) gene with birthplace on the risk of myocardial infarction (MI) and coronary atherosclerosis. METHOD APOE genotypes were analyzed in the Helsinki Sudden Death Study series comprising out-of-hospital deaths among males aged 33-70 years (n = 577), who were born in high (east, n = 273) or low (west, n = 304) CHD mortality area. RESULTS Eastern-born men ≤ 55 years carried 30% more often (P = 0.017) and older men 40% less often (P = 0.022) the APOE ϵ4 allele compared to western-born men (P = 0.003 for birthplace-by-age interaction). In multivariate analysis, the ϵ4 allele associated with the risk of out-of-hospital MI (odds ratio 2.58; 95% CI 1.20-5.55; P = 0.016) only in eastern-born men and with advanced atherosclerosis in both regions of origin, respectively. CONCLUSIONS Birthplace-bound risk of CHD was age-dependently modified by APOE ϵ4 allele, suggesting genetic differences in CHD susceptibility between early and late settlement regions in Finland and providing one explanation for the eastern high mortality.
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Affiliation(s)
- Petri Tyynelä
- School of Medicine, University of Tampere, Tampere, Finland.
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Beydoun MA, Beydoun HA, Kaufman JS, An Y, Resnick SM, O'Brien R, Ferrucci L, Zonderman AB. Apolipoprotein E ε4 allele interacts with sex and cognitive status to influence all-cause and cause-specific mortality in U.S. older adults. J Am Geriatr Soc 2013; 61:525-34. [PMID: 23581910 PMCID: PMC3628727 DOI: 10.1111/jgs.12156] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To confirm associations of apolipoprotein E (ApoE) ε4 carrier status, sex, and time-dependent cognitive status with mortality risk and to investigate these joint effects of these associations in a cohort of community-dwelling U.S. adults. DESIGN Prospective cohort study. SETTING The Baltimore Longitudinal Study of Aging (BLSA). PARTICIPANTS Of 3,047 BLSA participants aged 17 to 98 at first visit (60.1% male), 1,704 with complete ApoE genotype data were included, of whom 1,461 aged 50 and older with one or more visits were eligible. MEASUREMENTS Time to death from all, cardiovascular, and noncardiovascular causes. RESULTS Probability of survival was lower for ApoE ε4 carriers, particularly those who were older. A Cox proportional hazards model for all-cause mortality yielded a hazard ratio (HR) for ApoE ε4 carrier versus noncarriers of 1.31 (95% confidence interval (CI) = 1.02-1.68). This association was also found for cardiovascular mortality. Time-dependent all-cause dementia (HR = 1.73, 95% CI = 1.33-2.26) and mild cognitive impairment (HR = 1.95, 95% CI = 1.42-2.67) increased all-cause mortality risk, associations that were also detected for noncardiovascular mortality. When individuals were free of cognitive impairment, a dose-response relationship with ε4 alleles was found for all-cause mortality (HR = 1.40, 95% CI = 0.94-2.07 for 1 ε4; HR = 2.61, 95% CI = 1.12-6.07 for 2 ε4). After onset of Alzheimer's disease (AD), carrying only one ε4 allele resulted in an approximately 77% greater all-cause mortality risk than in noncarriers. ApoE ε4 carrier status increased all-cause mortality risk in men and interacted with time-dependent AD to increase the risk of this outcome (relative excess risk due to interaction = 2.15, 95% CI = 1.22-3.07). CONCLUSION ApoE ε4 carrier status was found to increase all-cause and cardiovascular mortality risks and interacted with sex and time-dependent AD status to affect all-cause mortality.
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Affiliation(s)
- May A Beydoun
- National Institute on Aging, National Institutes of Health, Intramural Research Program, Baltimore, MD 21224, USA.
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Chaudhary R, Likidlilid A, Peerapatdit T, Tresukosol D, Srisuma S, Ratanamaneechat S, Sriratanasathavorn C. Apolipoprotein E gene polymorphism: effects on plasma lipids and risk of type 2 diabetes and coronary artery disease. Cardiovasc Diabetol 2012; 11:36. [PMID: 22520940 PMCID: PMC3372424 DOI: 10.1186/1475-2840-11-36] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 04/23/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The most common apolipoprotein E (apoE) gene polymorphism has been found to influence plasma lipid concentration and its correlation with coronary artery disease (CAD) has been extensively investigated in the last decade. It is, however, unclear whether apoE gene polymorphism is also associated with increased risk of type 2 diabetes mellitus (T2DM). The knowledge of this study may provide the primary prevention for T2DM and CAD development before its initiation and progression. Therefore, this study was carried out to determine the association between apoE gene polymorphism and T2DM with and without CAD and its role in lipid metabolism. METHODS The case-control study was carried out on a total of 451 samples including 149 normal control subjects, 155 subjects with T2DM, and 147 subjects with T2DM complicated with CAD. The apoE gene polymorphism was tested by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Univariable and multivariable logistic regression analyses were used to identify the possible risks of T2DM and CAD. RESULTS A significantly increased frequency of E3/E4 genotype was observed only in T2DM with CAD group (p = 0.0004), whereas the ε4 allele was significantly higher in both T2DM (p = 0.047) and T2DM with CAD (p = 0.009) as compared with controls. E3/E4 genotype was also the independent risk in developing CAD after adjusting with established risk factors with adjusted odds ratio (OR) 2.52 (95%CI 1.28-4.97, p = 0.008). The independent predictor of individuals carrying ε4 allele still remained significantly associated with both CAD (adjusted OR 2.32, 95%CI 1.17-4.61, p = 0.016) and T2DM (adjusted OR 2.04, 95%CI 1.07-3.86, p = 0.029). After simultaneously examining the joint association of E3/E4 genotype combined with either obesity or smoking the risk increased to approximately 5-fold in T2DM (adjusted OR 4.93, 95%CI 1.74-13.98, p = 0.003) and 10-fold in CAD (adjusted OR 10.48, 95%CI 3.56-30.79, p < 0.0001). The association between apoE genotypes on plasma lipid levels was compared between E3/E3 as a reference and E4-bearing genotypes. E4-bearing genotypes showed lower HDL-C and higher VLDL-C and TG, whereas other values of plasma lipid concentrations showed no significant difference. CONCLUSIONS These results indicate that ε4 allele has influence on lipid profiles and is associated with the development of both T2DM with and without CAD, and furthermore, it increased the risk among the subjects with obesity and/or smoking, the conditions associated with high oxidative stress.
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Affiliation(s)
- Rajesh Chaudhary
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Das M, Pal S, Ghosh A. Apolipoprotein E gene polymorphism and dyslipidaemia in adult Asian Indians: A population based study from Calcutta, India. INDIAN JOURNAL OF HUMAN GENETICS 2011; 14:87-91. [PMID: 20300302 PMCID: PMC2840797 DOI: 10.4103/0971-6866.45000] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM: The study was aimed to determine the association of Apolipoprotein E (apo E) gene polymorphisms on lipid levels in Asian Indian population. METHODS: A total of 350 (184 males and 166 females) adult (30 years and above) Asian Indians of Calcutta and suburb participated in the study. Anthropometric measures, lipids profiles, and blood glucose measures were collected. Out of 350 subjects, a sample of 70 individuals was selected randomly for genotyping after adjusting for age and sex. The apo E gene polymorphisms were determined by agarose gel electrophoresis. RESULTS: The apo E polymorphism showed significant association with dyslipidaemia (P=0.0135) with ε3/4 combination has had the highest occurrence of dyslipidaemia and metabolic syndrome (MS) followed by ε4/4 <ε3/3 <ε2/4 <ε2/3 in decreasing order. CONCLUSIONS: The ε4 allele of apo E gene independent of other risk factors is associated with dyslipidaemia in particular with low HDLc and high TC: HDLc ratio.
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Affiliation(s)
- Mithun Das
- Post Graduate Department of Anthropology, Sree Chaitanya College, Habra, West Bengal, India
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Corella D, Portolés O, Arriola L, Chirlaque MD, Barrricarte A, Francés F, Huerta JM, Larrañaga N, Martínez C, Martinez-Camblor P, Molina E, Navarro C, Quirós JR, Rodríguez L, Sánchez MJ, Ros E, Sala N, González CA, Moreno-Iribas C. Saturated fat intake and alcohol consumption modulate the association between the APOE polymorphism and risk of future coronary heart disease: a nested case-control study in the Spanish EPIC cohort. J Nutr Biochem 2010; 22:487-94. [PMID: 20688498 DOI: 10.1016/j.jnutbio.2010.04.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 04/01/2010] [Indexed: 12/27/2022]
Abstract
The association is still not clear between the common APOE polymorphism and coronary heart disease (CHD) risk, nor its modulation by diet. Thus, our aim was to study the association between the APOE genotypes and incident CHD and how dietary fat and alcohol consumption modify these effects. We performed a nested case-control study in the Spanish European Prospective Investigation into Cancer and Nutrition cohort. Healthy men and women (41,440, 30-69 years) were followed up over a 10-year period, with the incident CHD cases being identified. We analyzed 534 incident CHD cases and 1123 controls. APOE, dietary intake and plasma lipids were determined at baseline. The APOE polymorphism was significantly associated with low-density lipoprotein cholesterol (LDL-C), and gene-alcohol interactions in determining LDL-C were detected. In the whole population, the E2 allele was significantly associated with a lower CHD risk than E3/E3 subjects [odds ratio (OR), 0.58; 95% confidence interval (CI), 0.38-0.89]. The E4 allele did not reach statistical significance vs. E3/E3 (OR, 1.17; 95% CI, 0.88-1.58). However, saturated fat intake modified the effect of the APOE polymorphism in determining CHD risk. When saturated fat intake was low (<10% of energy), no statistically significant association between the APOE polymorphism and CHD risk was observed (P=.682). However, with higher intake (≥10%), the polymorphism was significant (P=.005), and the differences between E2 and E4 carriers were magnified (OR for E4 vs. E2, 3.33; 95% CI, 1.61-6.90). Alcohol consumption also modified the effect of the APOE on CHD risk. In conclusion, in this Mediterranean population, the E2 allele is associated with lower CHD risk, and this association is modulated by saturated fat and alcohol consumption.
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Affiliation(s)
- Dolores Corella
- Genetic and Molecular Epidemiology Unit, Department of Preventive Medicine, University of Valencia, Valencia and CIBER Fisiopatología de la Obesidad y Nutrición, ISCIII, Spain.
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Drenos F, Kirkwood TBL. Selection on alleles affecting human longevity and late-life disease: the example of apolipoprotein E. PLoS One 2010; 5:e10022. [PMID: 20368805 PMCID: PMC2848859 DOI: 10.1371/journal.pone.0010022] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 03/13/2010] [Indexed: 11/28/2022] Open
Abstract
It is often claimed that genes affecting health in old age, such as cardiovascular and Alzheimer diseases, are beyond the reach of natural selection. We show in a simulation study based on known genetic (apolipoprotein E) and non-genetic risk factors (gender, diet, smoking, alcohol, exercise) that, because there is a statistical distribution of ages at which these genes exert their influence on morbidity and mortality, the effects of selection are in fact non-negligible. A gradual increase with each generation of the ε2 and ε3 alleles of the gene at the expense of the ε4 allele was predicted from the model. The ε2 allele frequency was found to increase slightly more rapidly than that for ε3, although there was no statistically significant difference between the two. Our result may explain the recent evolutionary history of the epsilon 2, 3 and 4 alleles of the apolipoprotein E gene and has wider relevance for genes affecting human longevity.
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Affiliation(s)
- Fotios Drenos
- Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, Tyne, United Kingdom.
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APOE-related mortality: Effect of dementia, cardiovascular disease and gender. Neurobiol Aging 2009; 30:1545-51. [DOI: 10.1016/j.neurobiolaging.2007.12.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Revised: 12/03/2007] [Accepted: 12/05/2007] [Indexed: 11/20/2022]
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Anuurad E, Yamasaki M, Shachter N, Pearson TA, Berglund L. ApoE and ApoC-I polymorphisms: association of genotype with cardiovascular disease phenotype in African Americans. J Lipid Res 2009; 50:1472-8. [PMID: 19252179 DOI: 10.1194/jlr.p900012-jlr200] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Apolipoproteins (apo) E and C-I are components of triglyceride (TG)-rich lipoproteins and impact their metabolism. Functional polymorphisms have been established in apoE but not in apoC-I. We studied the relationship between apoE and apoC-I gene polymorphisms and plasma lipoproteins and coronary artery disease (CAD) in 211 African Americans and 306 Caucasians. In African Americans but not in Caucasians, apoC-I H2-carriers had significantly lower total and LDL cholesterol and apoB levels, and higher glucose, insulin, and HOMA-IR levels compared with H1 homozygotes. Differences across CAD phenotypes were seen for the apoC-I polymorphism. African-American H2-carriers without CAD had significantly lower total cholesterol (P < 0.001), LDL cholesterol (P < 0.001), and apoB (P < 0.001) levels compared with H1 homozygotes, whereas no differences were found across apoC-I genotypes for African Americans with CAD. Among African-American apoC-I H1 homozygotes, subjects with CAD had a profile similar to the metabolic syndrome (i.e., higher triglyceride, glucose, and insulin) compared with subjects without CAD. For African-American H2-carriers, subjects with CAD had a pro-atherogenic lipid pattern (i.e., higher LDL cholesterol and apoB levels), compared with subjects without CAD. ApoC-I genotypes showed an ethnically distinct phenotype relationship with regard to CAD and CAD risk factors.
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Abstract
Pharmacogenetics has the potential to help guide treatment decisions by tailoring appropriate drugs and dosages to patients most likely to benefit. This straightforward clinical goal has led some to suggest that pharmacogenetic testing is free of ethical concerns. However, a number of potential risks and clinical uncertainties arise in considering the use of these new tools in clinical care. We propose a classification of pharmacogenetic tests to identify and prioritize the policy issues that will need to be addressed to ensure appropriate delivery of pharmacogenetic testing. We use the classification framework to consider the benefits and risks associated with ancillary information, timing of testing, and storage and retrieval of pharmacogenetic test results among health professionals. These issues have implications for informed consent and genetic counseling requirements, and for the role of health professionals.
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Anuurad E, Rubin J, Lu G, Pearson TA, Holleran S, Ramakrishnan R, Berglund L. Protective effect of apolipoprotein E2 on coronary artery disease in African Americans is mediated through lipoprotein cholesterol. J Lipid Res 2006; 47:2475-81. [PMID: 16888319 DOI: 10.1194/jlr.m600288-jlr200] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We studied the relationship of apolipoprotein E (apoE) isoforms and coronary artery disease (CAD) in 224 African Americans and 326 Caucasians undergoing diagnostic coronary angiography. The presence of CAD was defined as >50% stenosis in at least one artery. ApoE allele frequencies were 0.12, 0.62, and 0.26 for epsilon 2, epsilon 3, and epsilon 4, respectively, in African Americans and 0.08, 0.78, and 0.14 for epsilon 2, epsilon 3, and epsilon 4, respectively, in Caucasians. Among African Americans, CAD was present in 9 of 34 epsilon 2 carriers (26%), significantly smaller (P < 0.05) in proportion compared with 39 of 82 epsilon 3 carriers and 43 of 92 epsilon 4 carriers (48% and 47%, respectively), suggesting a protective effect of the epsilon 2 allele. No such difference was seen in Caucasians. In African Americans but not Caucasians, LDL cholesterol was lower in epsilon 2 carriers than in epsilon 3 and epsilon 4 carriers (106 vs. 127 and 134 mg/dl, respectively; P < 0.005). After adjusting for lipid levels, the association between apoE2 and CAD was no longer significant. Thus, the protective effect of apoE2 seen in African Americans could be explained by a favorable lipid profile in epsilon 2 carriers, whereas in Caucasians, the absence of such a protective effect could be attributable to the lack of effect of apoE2 on the lipid profile.
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Ravitsky V, Wilfond BS. Disclosing individual genetic results to research participants. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2006; 6:8-17. [PMID: 17085395 DOI: 10.1080/15265160600934772] [Citation(s) in RCA: 209] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Investigators and institutional review boards should integrate plans about the appropriate disclosure of individual genetic results when designing research studies. The ethical principles of beneficence, respect, reciprocity, and justice provide justification for routinely offering certain results to research participants. We propose a result-evaluation approach that assesses the expected information and the context of the study in order to decide whether results should be offered. According to this approach, the analytic validity and the clinical utility of a specific result determine whether it should be offered routinely. Different results may therefore require different decisions even within the same study. We argue that the threshold of clinical utility for disclosing a result in a research study should be lower than the threshold used for clinical use of the same result. The personal meaning of a result provides additional criteria for evaluation. Finally, the context of the study allows for a more nuanced analysis by addressing the investigators' capabilities for appropriate disclosure, participants' alternative access to the result, and their relationship with the investigators. This analysis shows that the same result may require different decisions in different contexts.
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Guang-da X, Xiang-Jiu Y, Lin-Shuang Z, Zhi-Song C, Yu-Sheng H. Apolipoprotein e4 allele and the risk of CAD death in type 2 diabetes mellitus with ischaemia electrocardiographic change. Diabetes Res Clin Pract 2005; 68:223-9. [PMID: 15936464 DOI: 10.1016/j.diabres.2004.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2003] [Revised: 08/13/2004] [Accepted: 09/06/2004] [Indexed: 10/26/2022]
Abstract
The presence of apolipoprotein (Apo) e4 allele is reported to be associated with the increased risk of coronary artery disease (CAD), as well as the impairment of endothelium-dependent arterial dilation in type 2 diabetes mellitus. Therefore, we hypothesized that Apo e4 allele increases the death risk from coronary artery disease in type 2 diabetes with ischaemia electrocardiographic change. From January 1993 to December 1999, 46 type 2 diabetic patients with e4/4 or e4/3, 96 with e3/3 and 45 with e2/2 or e3/2 genotypes were recruited. All subjects were unrelated elderly type 2 diabetic patients with ischaemia electrocardiographic change, aged 60-87 years, and their cardiac function were all the class I stage at their time of enrollment. A follow-up study of 3-10 years was undergone. The results are as follows: At baseline, serum total cholesterol and low-density lipoprotein (LDL) cholesterol concentrations were higher in subjects with e4/3 or e4/4 than in subjects with e2/2 or e3/2 (p<0.05). Lipoprotein(a) concentration was lower in subjects with e2/2 or e3/2 than in subjects with e3/3 and e4/3 or e4/4 (p < 0.05). During the 3-10 years follow-up period, a total of 55 patients who died from CAD were recorded in this sample. Compared with patients with e3/3 (p = 0.024) and patients with e2/2 or e2/3 genotypes (p = 0.002), the mortality rate of CAD in patients with e4/3 or e4/4 genotypes was the highest (47.8%). Stepwise discriminant analysis revealed that in the diabetic population studied Apo e4 allele was independently and significantly associated with CAD death (B = 0.65). However, the strength of the association decreased (B = 0.44) when total cholesterol, LDL-cholesterol and lipoprotein(a) were included in the model. Therefore, we concluded that Apo e4 allele increases the risk of CAD death in elderly type 2 diabetes mellitus with ischaemia electrocardiographic change.
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Affiliation(s)
- Xiang Guang-da
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command of PLA, Wuhan 430070, PR China.
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Talmud PJ, Lewis SJ, Hawe E, Martin S, Acharya J, Marmot MG, Humphries SE, Brunner EJ. No APOEepsilon4 effect on coronary heart disease risk in a cohort with low smoking prevalence: the Whitehall II study. Atherosclerosis 2005; 177:105-12. [PMID: 15488872 DOI: 10.1016/j.atherosclerosis.2004.06.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2004] [Accepted: 06/22/2004] [Indexed: 11/15/2022]
Abstract
Carriers of the APOEepsilon4 allele have consistently shown higher, and epsilon2 carriers have lower, plasma cholesterol and coronary heart disease (CHD) risk compared with epsilon3 homozygotes. An epsilon4:smoking interaction was observed in NPHSII, consistent with context dependency of the epsilon4 effect on CHD risk. In this study, APOE genotype was determined in 3787 male British civil servants followed for fatal and non-fatal myocardial infarction for median of 5.8 years, with 159 validated CHD events. APOE genotype was associated with expected effects on lipid traits (all P <0.0001). We tested the hypothesis that APOEepsilon4 was not a risk factor for CHD among non-smokers. In non-smokers, the odds ratio (OR) for epsilon2 and epsilon4 carriers were 0.51 (0.27, 0.97) and 0.70 (0.46, 1.08), respectively, compared with epsilon3 homozygotes. Thus epsilon2 carriers showed expected risk-protection, but despite 80% power to detect an OR in epsilon4 subjects of 1.71 (i.e. of magnitude increase reported in prospective studies), the epsilon4 non-smokers showed no increased risk compared with epsilon3 homozygotes. Smoking prevalence in this study was low (12.8%), but smokers had higher CHD risk which was of similar magnitude in risk in all genotypes [(OR 1.57 (1.03, 2.40)]. These data, therefore, provide strong corroborative evidence that there is no elevated risk of CHD in epsilon4 non-smokers, but failed to confirm the epsilon4:smoking interaction on risk. This supports the context dependency of the epsilon4 risk effect, but the low smoking incidence in the Whitehall men reduced our ability to examine a smoking:genotype interaction.
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Affiliation(s)
- Philippa J Talmud
- British Heart Foundation Laboratories, Department of Medicine, Centre for Cardiovascular Genetics, Rayne Building, University College London, 5 University Street, London WC1E 6JF, UK.
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17
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Strandhagen E, Zetterberg H, Aires N, Palmér M, Rymo L, Blennow K, Thelle DS. The apolipoprotein E polymorphism and the cholesterol-raising effect of coffee. Lipids Health Dis 2004; 3:26. [PMID: 15571629 PMCID: PMC539242 DOI: 10.1186/1476-511x-3-26] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2004] [Accepted: 11/30/2004] [Indexed: 12/21/2022] Open
Abstract
Background The response of serum cholesterol to diet may be affected by the apolipoprotein E (APOE) ε2/ε3/ε4 polymorphism, which also is a significant predictor of variation in the risk of coronary heart disease (CHD) and CHD death. Here, we test the hypothesis that the APOE polymorphism may modulate the cholesterol-raising effect of coffee. Objective We determined the effect of a coffee abstention period and a daily intake of 600 mL coffee on serum cholesterol and triglycerides with respect to the APOE polymorphism. Design 121 healthy, non-smoking men (22%) and women (78%) aged 29–65 years, took part in a study with four intervention periods: 1 and 3) a coffee free period of three weeks, 2 and 4) 600 mL coffee/day for four weeks. Results APOE ε2 positive individuals had significantly lower total cholesterol concentration at baseline (4.68 mmol/L and 5.28 mmol/L, respectively, p = 0.01), but the cholesterol-raising effect of coffee was not influenced significantly by APOE allele carrier status. Conclusions The APOE ε 2 allele is associated with lower serum cholesterol concentration. However, the APOE polymorphism does not seem to influence the cholesterol-raising effect of coffee.
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Affiliation(s)
- Elisabeth Strandhagen
- the Cardiovascular Institute, Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden
| | - Henrik Zetterberg
- Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital/Sahlgrenska, Göteborg, Sweden
- Institute of Clinical Neuroscience, Department of Experimental Neuroscience, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden
| | - Nibia Aires
- the Cardiovascular Institute, Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden
| | - Mona Palmér
- Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital/Sahlgrenska, Göteborg, Sweden
| | - Lars Rymo
- Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital/Sahlgrenska, Göteborg, Sweden
| | - Kaj Blennow
- Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital/Sahlgrenska, Göteborg, Sweden
- Institute of Clinical Neuroscience, Department of Experimental Neuroscience, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden
| | - Dag S Thelle
- the Cardiovascular Institute, Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden
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18
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Guang-da X, You-ying L, Zhi-song C, Yu-sheng H, Xiang-jiu Y. Apolipoprotein e4 allele is predictor of coronary artery disease death in elderly patients with type 2 diabetes mellitus. Atherosclerosis 2004; 175:77-81. [PMID: 15186949 DOI: 10.1016/j.atherosclerosis.2004.02.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Accepted: 02/27/2004] [Indexed: 10/26/2022]
Abstract
The presence of the apolipoprotein (Apo) e4 allele is reported to be associated with the increased risk of coronary artery disease (CAD), as well as the impairment of endothelium-dependent dilation in type 2 diabetes mellitus. Therefore, we hypothesized that the Apo e4 allele increases the death risk from coronary artery disease in type 2 diabetes. From January 1993 to December 1999, 36 type 2 diabetic patients with e4/4 or e4/3, 62 with e3/3 and 33 with e2/2 or e3/2 genotypes were recruited. All subjects were unrelated, elderly, type 2 diabetic patients with coronary artery disease, aged 60-84 years, with cardiac function at the Class I stage at time of enrollment. A follow-up study of 3-10 years was undergone. The results are as follows: At baseline, serum total cholesterol and low density lipoprotein (LDL) cholesterol concentrations were higher in subjects with e4/3 or e4/4 than in subjects with e2/2 or e3/2 (P = 0.026). Lipoprotein(a) concentration was lower in subjects with e2/2 or e3/2 than in subjects with e3/3 (P = 0.044) and e4/3 or e4/4 (P = 0.038). During the 3-10 years follow-up period, a total of 39 patients who died from CAD was recorded in this sample. Compared with patients with e3/3 (P = 0.030) and patients with e2/2 or e3/2 genotypes (P = 0.001), the mortality rate of CAD in patients with e4/3 or e4/4 genotypes was the highest (50%). Stepwise discriminant analysis revealed that in the diabetic population studied the Apo e4 allele was independently and significantly associated with CAD death (B = 0.64). However, the strength of the association decreased (B = 0.48) when total cholesterol, LDL-cholesterol and lipoprotein(a) were included in the model. Therefore, we concluded that Apo e4 allele increases the risk of CAD death in elderly patients with type 2 diabetes mellitus.
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Affiliation(s)
- Xiang Guang-da
- The Department of Endocrinology, Guangzhou Command Wuhan General Hospital of PLA, Wuhan 430070, PR China.
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19
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Templeton AR, Maxwell T, Posada D, Stengård JH, Boerwinkle E, Sing CF. Tree scanning: a method for using haplotype trees in phenotype/genotype association studies. Genetics 2004; 169:441-53. [PMID: 15371364 PMCID: PMC1448891 DOI: 10.1534/genetics.104.030080] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We use evolutionary trees of haplotypes to study phenotypic associations by exhaustively examining all possible biallelic partitions of the tree, a technique we call tree scanning. If the first scan detects significant associations, additional rounds of tree scanning are used to partition the tree into three or more allelic classes. Two worked examples are presented. The first is a reanalysis of associations between haplotypes at the Alcohol Dehydrogenase locus in Drosophila melanogaster that was previously analyzed using a nested clade analysis, a more complicated technique for using haplotype trees to detect phenotypic associations. Tree scanning and the nested clade analysis yield the same inferences when permutation testing is used with both approaches. The second example is an analysis of associations between variation in various lipid traits and genetic variation at the Apolipoprotein E (APOE) gene in three human populations. Tree scanning successfully identified phenotypic associations expected from previous analyses. Tree scanning for the most part detected more associations and provided a better biological interpretative framework than single SNP analyses. We also show how prior information can be incorporated into the tree scan by starting with the traditional three electrophoretic alleles at APOE. Tree scanning detected genetically determined phenotypic heterogeneity within all three electrophoretic allelic classes. Overall, tree scanning is a simple, powerful, and flexible method for using haplotype trees to detect phenotype/genotype associations at candidate loci.
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Affiliation(s)
- Alan R Templeton
- Department of Biology, Washington University, St. Louis, Missouri 63130-4899, USA.
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20
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Human Apolipoprotein E concentration in response to diseases and therapeutic treatments. Drug Dev Res 2002. [DOI: 10.1002/ddr.10065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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21
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Gerdes LU, Vestergaard P, Hermann AP, Mosekilde L. Regional and hormone-dependent effects of apolipoprotein E genotype on changes in bone mineral in perimenopausal women. J Bone Miner Res 2001; 16:1906-16. [PMID: 11585357 DOI: 10.1359/jbmr.2001.16.10.1906] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We studied 479 perimenopausal Danish women aged 45-58 years to examine differences between APOE genotypes with respect to (1) baseline total body bone mineral density (BMD) and densities measured in five different regions (ultradistal forearm, proximal forearm, lumbar spine, femoral neck, and total hip region); (2) serum levels of alkaline phosphatase, bone isoenzyme alkaline phosphatase, osteocalcin, parathyroid hormone (PTH), 25-hydroxyvitamin D, and urine hydroxyproline/creatinine excretion ratio; and (3) changes in bone mineral during 5 years of follow-up. Baseline BMDs were identical, whereas serum levels of alkaline phosphatase and its bone isoenzyme were higher in women with APOE 2-2 and APOE 2-3 than in women with APOE 3-3 and APOE 3-4 and lower in women with APOE 4-4. Among women not receiving hormonal-replacement therapy (HRT; n = 262), those with APOE 2-2 and APOE 2-3 had 30-40% lower rates of femoral neck and total hip bone mineral loss than women with APOE 3-3 and APOE 3-4, whereas the rates of mineral loss in other skeletal regions did not differ between these APOE genotypes. Women with APOE 4-4 appeared to have lower rates of bone mineral loss in all regions. Women treated with hormones throughout the follow-up period (n = 113) gained bone mineral, and women with APOE 3-4 and APOE 4-4 gained relatively more mineral than other women. A comparison of untreated and treated women with APOE 2-3, APOE 3-3, and APOE 3-4 suggests a possible modification of the effect of APOE genotype by HRT. In conclusion, the common APOE polymorphism has a complex effect on bone metabolism in perimenopausal Danish women including possible modification by hormone use: (1) among women not receiving HRT, those with APOE*2 have lower bone mineral losses in the femoral neck and hip region than other women, and (2) among women receiving HRT, those with APOE*4 gain more bone mineral than other women.
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Affiliation(s)
- L U Gerdes
- Department of Internal Medicine and Cardiology, Aarhus University Hospital, Denmark
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22
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Delcourt C, Michel F, Colvez A, Lacroux A, Delage M, Vernet MH. Associations of cardiovascular disease and its risk factors with age-related macular degeneration: the POLA study. Ophthalmic Epidemiol 2001; 8:237-49. [PMID: 11471092 DOI: 10.1076/opep.8.4.237.1613] [Citation(s) in RCA: 152] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The POLA study (June 1995 through July 1997) is a population-based study on cataract and age-related macular degeneration (AMD) and their risk factors in 2584 residents of Séte (South of France), aged 60--95 years. Classification of AMD was performed on 50 degrees fundus photographs, according to an international classification. The presence of cardiovascular disease and its risk factors was determined by interviewer-based questionnaire, clinical examination (anthropometry, blood pressure) and fasting plasma measurements. Using a logistic model adjusted for age and gender, late AMD was not significantly associated with a history of cardiovascular disease, diabetes, use of hypocholesterolemic drugs, hypertension, blood pressure or plasma lipids. Obese subjects (body mass index greater than 30 kg/m( 2)) had a 2.29-fold (95% confidence interval (CI): 1.00--5.23) and 1.54-fold (CI: 1.05--2.26) increased risk of late AMD and pigmentary abnormalities in comparison with lean subjects. Finally, the risk of soft drusen was decreased in those subjects with a history of cardiovascular disease (odds-ratio (OR) = 0.72, CI: 0.54--0.97), and increased with increasing levels of HDL-cholesterol (OR = 1.52, CI: 1.14--2.02). None of these results were modified by further adjustments for smoking, educational level and plasma alpha-tocopherol. These results need to be confirmed by other studies, which ideally should be longitudinal and prospective.
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Affiliation(s)
- C Delcourt
- INSERM Unité 500, Montpellier, 34093, France.
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23
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Batalla A, Alvarez R, Reguero JR, Hevia S, Iglesias-Cubero G, Alvarez V, Cortina A, González P, Celada MM, Medina A, Coto E. Synergistic Effect between Apolipoprotein E and Angiotensinogen Gene Polymorphisms in the Risk for Early Myocardial Infarction. Clin Chem 2000. [DOI: 10.1093/clinchem/46.12.1910] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractBackground: Several studies based on different populations worldwide have described an association between cardiovascular diseases and genetic variations in the apolipoprotein E (APOE), angiotensinogen (AGT), angiotensin receptor type 1 (AT1R), and angiotensin-converting enzyme (ACE) genes. In addition, there is growing evidence of an interaction between hypercholesterolemia and the renin-angiotensin system in the risk for hypertension and atherosclerosis.Methods: To determine whether the DNA polymorphisms in APOE (ε2, ε3, and ε4 alleles), AGT (M235T), AT1R (1166 A/C), and ACE (I/D) are associated with early onset of myocardial infarction (MI), we genotyped 220 patients and 200 controls <55 years of age. Patients and controls were males from the same homogeneous Caucasian population. Data concerning hypertension, diabetes, and tobacco consumption were recorded. The lipid profiles of patients and controls were also determined.Results: APOE, ACE, AGT, and AT1R allele and genotype frequencies did not differ between patients and controls. None of these polymorphisms was related to the biochemical values in patients or controls. The frequency of individuals who were both APOEε4 allele carriers and AGT-TT homozygotes was significantly higher in patients than in controls (11% vs 3.5%; P = 0.0037). In patients, the frequency of ε4 carriers was significantly higher (P <0.00001) in those who were AGT-TT (46%) than those who were AGT-MT/MM (14%). Mean cholesterol was significantly higher in AGT-TT + APOE ε34/44 patients than in the TM/MM + ε34/44 or TT + ε23/33 genotypes (P = 0.029).Conclusions: Our data suggest a synergistic effect between the APOE and AGT polymorphisms and early MI. The increased risk could be mediated in part through higher cholesterol concentrations among individuals who are AGT-TT + APOEε4 allele carriers.
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Affiliation(s)
- Alberto Batalla
- Servicio Cardiologı́a, Hospital de Cabueñes, 33280 Gijón, Spain
| | - Ruth Alvarez
- Laboratorio Genética Molecular-Instituto Investigación Nefrológica and
| | - Julián R Reguero
- Servicio Cardiologı́a, Hospital Central de Asturias, 33006 Oviedo, Spain
| | - Sergio Hevia
- Servicio Cardiologı́a, Hospital Central de Asturias, 33006 Oviedo, Spain
| | | | - Victoria Alvarez
- Laboratorio Genética Molecular-Instituto Investigación Nefrológica and
| | - Arturo Cortina
- Servicio Cardiologı́a, Hospital Central de Asturias, 33006 Oviedo, Spain
| | - Pelayo González
- Laboratorio Genética Molecular-Instituto Investigación Nefrológica and
| | - Mateo M Celada
- Servicio Medicina Interna, Hospital Monte Naranco, E-33006 Oviedo, Spain
| | - Alfonso Medina
- Servicio Medicina Interna, Hospital Monte Naranco, E-33006 Oviedo, Spain
| | - Eliecer Coto
- Laboratorio Genética Molecular-Instituto Investigación Nefrológica and
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24
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Schiele F, De Bacquer D, Vincent-Viry M, Beisiegel U, Ehnholm C, Evans A, Kafatos A, Martins MC, Sans S, Sass C, Visvikis S, De Backer G, Siest G. Apolipoprotein E serum concentration and polymorphism in six European countries: the ApoEurope Project. Atherosclerosis 2000; 152:475-88. [PMID: 10998477 DOI: 10.1016/s0021-9150(99)00501-8] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
As part of the ApoEurope Project, the apolipoprotein E (apo E) serum concentration and polymorphism were determined in 6934 healthy subjects aged 25-64 years recruited in six European countries: Finland; France; Greece; Northern Ireland; Portugal and Spain. Age and sex influenced apo E concentration with concentrations being significantly higher in men than in women for those aged between 25 and 44 years. The age effect differed between the sexes after the age of 44 years, displaying a linear increase in women and a plateau in men. As expected, the serum apo E concentration was highest in varepsilon2 carriers and lowest in varepsilon4 carriers in each country with a significantly higher frequency of the varepsilon4 allele in the northern regions. The main finding of this study was a clear increasing North-South gradient in serum apo E concentration independent of age, sex and apo E genotype. In subjects aged <45 years and with the varepsilon3/varepsilon3 genotype, apo E concentration was higher in the South-East (Greece) as compared to the North by 20% for men and 32% for women. In addition to the genetic polymorphism, the geographical area is an important factor to take into account when studying serum apo E concentration in multicentre studies and defining reference values.
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Affiliation(s)
- F Schiele
- Laboratoire du Centre de Médecine Préventive, 2, avenue du Doyen Jacques Parisot, 54500, Vandoeuvre-lès-Nancy, France
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25
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Gerdes LU, Jeune B, Ranberg KA, Nybo H, Vaupel JW. Estimation of apolipoprotein E genotype-specific relative mortality risks from the distribution of genotypes in centenarians and middle-aged men: apolipoprotein E gene is a "frailty gene," not a "longevity gene". Genet Epidemiol 2000; 19:202-10. [PMID: 11015124 DOI: 10.1002/1098-2272(200010)19:3<202::aid-gepi2>3.0.co;2-q] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We developed a method to estimate genotype-specific average relative mortality risk, R, from genotype distributions in cross-sectional studies of people belonging to different age-groups, and applied the method to new data from a study of apolipoprotein E genotypes (apoE) in 177 Danish centenarians and data from a study of 40-year-old Danish men. Twenty-one percent of the centenarians were epsilon 2-carriers (genotypes epsilon 2 epsilon 2 and epsilon 3 epsilon 2) and 15% were epsilon 4-carriers (genotypes epsilon 4 epsilon 4 and epsilon 4 epsilon 3) compared to 13 and 29%, respectively, of the young men. The R-values were 0.95 (95% CI 0.88 to 1.02) for epsilon 2-carriers and 1.13 (95% CI 1.05 to 1.22) for epsilon 4-carriers, using epsilon 3 epsilon 3- and epsilon 4 epsilon 2 genotypes as reference. Corresponding values for epsilon 4-carriers were obtained by using published data from a French and a Finnish study of centenarians, whereas the values for epsilon 2-carriers were about 0.90 with these data. The method to estimate mortality risk and the results associate with the view that the apoE gene is a "frailty gene." On the other hand, if odds ratios are used to summarize data from studies of this kind, they are more impressive and may propagate the misconception that apoE is a "longevity gene".
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Affiliation(s)
- L U Gerdes
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark.
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26
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Siest G, Bertrand P, Herbeth B, Vincent-Viry M, Schiele F, Sass C, Visvikis S. Apolipoprotein E polymorphisms and concentration in chronic diseases and drug responses. Clin Chem Lab Med 2000; 38:841-52. [PMID: 11097338 DOI: 10.1515/cclm.2000.122] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Apolipoprotein (apo) E is an important circulating and tissue protein involved in cholesterol homeostasis and many other functions. The common polymorphism in the coding region of the gene, four polymorphisms in the promoter region, other additional single nucleotide polymorphisms, as well as several apo E variants have been identified. The common coding polymorphism strongly influences the lipid metabolism and the circulating concentration of apo E itself. This polymorphism is at the origin of the implication of apo E in cardiovascular and neurodegenerative diseases, but also of the relation of apo E with longevity. Probably due to its many metabolic and functional consequences, apo E polymorphism has been shown to influence the responses of patients to several drugs (fibrates, statins, hormone replacement therapy, anti-Alzheimer drugs) or environmental interventions (black tea, alcohol, diet). Apo E genotyping may be clinically helpful in defining the risk of patients and their responses to therapeutics. Finally, circulating apo E concentration appears to be altered in diseases and can be modulated by some of the drugs cited above. This parameter can thus also give interesting clinical information and could be a therapeutic target, providing it is validated. At the present time, we cannot exclude that apo E concentration may be the most prominent apo E parameter to be considered in health and disease, while apo E polymorphisms would represent only secondary parameters influencing apo E concentration.
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Affiliation(s)
- G Siest
- Centre de Médecine Préventive, Université Henri Poincaré Nancy I, INSERM U525, Vandoeuvre-lès-Nancy, France.
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Abstract
To be efficacious, dietary supplements must either provide a nutrient that is normally undersupplied to cells or exert a pharmacologic effect on cellular processes. In the first case, optimal function is achieved when a nutrient required by the organism reaches a specific concentration within the cell. A supplement has benefit only when the normal intake of a bioavailable form of a nutrient is lower than the amount that would provide maximum benefit as judged from all biological perspectives. Metabolic, environmental, and genetic factors can make individual nutrient requirements differ from the estimated needs calculated from population-based data. For example, under certain circumstances intracellular antioxidants may be depleted and a dietary supplement might restore optimal antioxidant protection. In the second case, the dietary supplement contains a constituent that is normally not required by the cell, but this substance is capable of altering normal cell function. For example, herbal preparations may contain ephedrine (a drug), which might alter heart rate so that the amount of blood pumped by the heart is enhanced. An understanding of how the variation in nutrient requirements comes about and of the pharmacologic actions of nutrient supplements can help to identify which individuals are most likely to benefit from dietary supplements.
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Affiliation(s)
- S H Zeisel
- School of Public Health and the School of Medicine, University of North Carolina at Chapel Hill, 27599-7400, USA.
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28
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Gerdes LU, Lindholt JS, Vammen S, Henneberg EW, Fasting H. Apolipoprotein E genotype is associated with differential expansion rates of small abdominal aortic aneurysms. Br J Surg 2000; 87:760-5. [PMID: 10848855 DOI: 10.1046/j.1365-2168.2000.01486.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The common polymorphism of the apolipoprotein E (APOE) gene is associated with differential risk of atherosclerosis; the gene could be a candidate gene in abdominal aortic aneurysms (AAA). METHODS APOE genotypes were determined in 57 men aged 65-73 years with a small AAA (30-50 mm). The patients were included in a population ultrasonographic screening programme and were followed with at least two examinations during an interval of 2-4.5 years. The AAA expansion rates in patients with four different APOE genotypes were studied, with adjustment for initial AAA size and smoking. RESULTS APOE genotype was a significant determinant of AAA expansion rate (P = 0.001). The adjusted mean (95 per cent confidence interval) rate was 2.1 (1.7-2.6) mm/year in 31 men with genotype E3E3, 1.3 (0.7-1.9) mm/year in 17 men with E3E4, 3.1 (2.0-4. 1) mm/year in six men with E2E3 and 4.2 (2.7-5.6) mm/year in three men with E2E4. The mean expansion rate was 2.2 (1.5-2.8) mm/year in non-smokers and 3.0 (2.5-3.6) mm/year in smokers (P = 0.014). CONCLUSION APOE genotype seems to influence AAA expansion rate, but the effects of the individual genotypes, in particular E3E3 and E3E4, are contradictory when compared with the effects of the genotypes on risk of atherosclerosis.
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Affiliation(s)
- L U Gerdes
- Department of Clinical Biochemistry, Aarhus University Hospital, Denmark
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29
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Frikke-Schmidt R, Tybjaerg-Hansen A, Steffensen R, Jensen G, Nordestgaard BG. Apolipoprotein E genotype: epsilon32 women are protected while epsilon43 and epsilon44 men are susceptible to ischemic heart disease: the Copenhagen City Heart Study. J Am Coll Cardiol 2000; 35:1192-9. [PMID: 10758960 DOI: 10.1016/s0735-1097(00)00520-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We tested the hypothesis that risk of ischemic heart disease (IHD) differs as a function of apolipoprotein E (APOE) genotype in women and men. BACKGROUND Apolipoprotein E genotype influences lipids and lipoproteins and, therefore, possibly the risk of IHD. METHODS We genotyped 9,241 white women and men from the general population and 940 white women and men with IHD. RESULTS Test of interaction suggested that APOE genotype may influence risk of IHD differently in women and men (p = 0.07). After age adjustment, the odds ratio (OR) for IHD for epsilon32 versus epsilon33 women was 0.57 (95% confidence interval [CI]: 0.35 to 0.94) while epsilon43 and epsilon44 versus epsilon33 men had ORs of 1.16 (0.96 to 1.41) and 1.58 (1.01 to 2.45). After adjustment for age and other conventional cardiovascular risk factors, the equivalent ORs were for epsilon32 women 0.38 (0.18 to 0.79), for epsilon43 men 1.35 (1.02-1.78) and for epsilon44 men 1.58 (0.80 to 3.08). Equivalent ORs for epsilon43 and epsilon44 versus epsilon33 women and for epsilon32 versus epsilon33 men were all close to 1.0 and nonsignificant. Of the total risk of IHD relative to the epsilon33 genotype, the fraction attributed to epsilon32 in women was -9%, while the fractions attributed to epsilon43 and epsilon44 in men were +8% and +2%. CONCLUSIONS Relative to epsilon33 individuals, epsilon32 women are protected while epsilon43 and epsilon44 men are particularly susceptible to IHD.
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Affiliation(s)
- R Frikke-Schmidt
- Department of Clinical Biochemistry, Herlev University Hospital, Denmark
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Trieu VN, Uckun FM. Apolipoprotein E and apolipoprotein D expression in a murine model of singlet oxygen-induced cerebral stroke. Biochem Biophys Res Commun 2000; 268:835-41. [PMID: 10679292 DOI: 10.1006/bbrc.2000.2205] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Apolipoprotein E (apoE)-deficient mice exhibit neuronal abnormalities similar to those in Alzheimer's disease and enhanced sensitivity to stroke-associated injuries. Here, we show that apoE deficiency results in impaired microglia/macrophage recruitment and accumulation after cerebral infarct. Astrogliosis and apolipoprotein D (apoD) expression are unaffected, suggesting that the neurological abnormalities of apoE-deficient mice could be due to impaired microglia/macrophage recruitment/accumulation, which is important for the clearance of neurodegenerative products via reverse cholesterol transport. To our knowledge, the results presented herein provide the first experimental evidence that brain microglia/macrophage recruitment/accumulation is affected by apoE deficiency. The insights gained from this study should facilitate the elucidation of the role of apoE in neurological disorders such as dementia with stroke and Alzheimer's disease.
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Affiliation(s)
- V N Trieu
- Department of Cardiovascular Biology, Department of Molecular Epidemiology, Parker Hughes Institute, 2665 Long Lake Road, St. Paul, Minnesota 55113, USA
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Stengård JH, Kardia SL, Tervahauta M, Ehnholm C, Nissinen A, Sing CF. Utility of the predictors of coronary heart disease mortality in a longitudinal study of elderly Finnish men aged 65 to 84 years is dependent on context defined by Apo E genotype and area of residence. Clin Genet 1999; 56:367-77. [PMID: 10668927 DOI: 10.1034/j.1399-0004.1999.560505.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A common assumption underlying most genetic studies is that individuals with different genotypes respond similarly to exposure to internal (epigenetic and background genotype effects) and external (ecological) environments. Here we evaluate whether this assumption is true in individuals with different genotypes of the gene coding for the apolipoprotein E (Apo E) molecule, an important determinant of the metabolic fate of plasma lipids and lipoproteins. We addressed whether the utility of known risk factors of coronary heart disease (CHD) in the prediction of CHD death in a 5-year follow-up is the same for the two most common Apo E genotypes, epsilon3/3 and epsilon4/3, in two cohorts of elderly Finnish men (age at baseline: 65-84 years), one in Eastern and the other in Southwestern Finland. The CHD mortality rate was higher in the epsilon4/3 than in the epsilon3/3 genotype in both cohorts (11.1 versus 7.8%, Pr = 0.281 in the Eastern cohort and 19.6 versus 8.2%, Pr = 0.002 in the Southwestern cohort). In the Eastern cohort, serum high density lipoprotein (HDL) cholesterol level was identified as a strong predictor of CHD death in the epsilon3/3 genotype (beta = -2.155, Pr = 0.019). In the Southwestern cohort, age (beta = 0.139, Pr = 0.006), body mass index (BMI) (beta = 0.149, Pr = 0.016), and serum total cholesterol level (beta = 0.453, Pr = 0.051) were identified as strong predictors in the epsilon3/3 genotype, as were smoking (beta = 0.236, Pr = 0.008) and BMI (beta = -0.124, Pr = 0.057) in the epsilon4/3 genotype. The latter observation indicates that in Southwestern Finland the probability of CHD death decreases with increasing BMI in elderly men with the epsilon4/3 genotype, while in their counterparts with the epsilon3/3 genotype the risk increases with increasing BMI. This difference was statistically significant (Pr = 0.002). These observations clearly argue against the assumption that individuals with different genotypes respond similarly to exposures to internal and/or external environments. These observations are consistent with a complex pathobiology of CHD involving biochemical and physiological agents that are under the influence of interactions between genetic and environmental factors. Information about these interactions is necessary for developing a more precise risk assessment and ultimately to improve public health and clinical strategies to prevent this devastating disease both at the individual and population levels.
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Affiliation(s)
- J H Stengård
- National Public Health Institute, Helsinki, Finland.
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Huang Y, Liu XQ, Rall SC, Mahley RW. Apolipoprotein E2 reduces the low density lipoprotein level in transgenic mice by impairing lipoprotein lipase-mediated lipolysis of triglyceride-rich lipoproteins. J Biol Chem 1998; 273:17483-90. [PMID: 9651338 DOI: 10.1074/jbc.273.28.17483] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Apolipoprotein (apo) E2 is often associated with low levels of low density lipoprotein (LDL) cholesterol and high levels of plasma triglycerides in humans. Mice expressing apoE2 also have low LDL levels. To evaluate the possible role of the LDL receptor in the cholesterol-lowering effect of apoE2, we bred transgenic mice expressing low levels of apoE2 with LDL receptor-null mice (hE2(+/0), LDLR-/-). Even in the absence of the LDL receptor, plasma total and LDL cholesterol levels decreased progressively with increasing levels of plasma apoE2. At plasma apoE2 levels >20 mg/dl, LDL cholesterol was approximately 45% lower than in LDLR-/- mice. Thus, the LDL cholesterol-lowering effect of apoE2 is independent of the LDL receptor. In contrast, plasma triglyceride levels increased (mostly in very low density lipoproteins (VLDL) and intermediate density lipoproteins (IDL)) progressively as apoE2 levels increased. At plasma apoE2 levels >20 mg/dl, triglycerides were approximately 150% higher than in LDLR-/- mice. Furthermore, in apoE-null mice (hE2(+/0), mE-/-), apoE2 levels also correlated positively with plasma triglyceride levels, suggesting impaired lipolysis in both hE2(+/0),LDLR-/- and hE2(+/0),mE-/- mice. Incubating VLDL or IDL from the hE2(+/0),LDLR-/- or the hE2(+/0),mE-/- mice with mouse postheparin plasma inhibited lipoprotein lipase-mediated lipolysis of apoE2-containing VLDL and IDL by approximately 80 and approximately 70%, respectively, versus normal VLDL and IDL. This observation was confirmed by studies with triglyceride-rich emulsion particles, apoE2, and purified lipoprotein lipase. Furthermore, apoE2-containing VLDL had much less apoC-II than normal VLDL. Adding apoC-II to the incubation partially corrected the apoE2-impaired lipolysis in apoE2-containing VLDL or IDL and corrected it completely in apoE2-containing emulsion particles. Thus, apoE2 lowers LDL cholesterol by impairing lipoprotein lipase-mediated lipolysis of triglyceride-rich lipoproteins (mostly by displacing or masking apoC-II). Furthermore, the effects of apoE2 on both plasma cholesterol and triglyceride levels are dose dependent and act via different mechanisms. The increase in plasma cholesterol caused by apoE2 is due mostly to impaired clearance, whereas the increase in plasma triglycerides is caused mainly by apoE2-impaired lipolysis of triglyceride-rich lipoproteins.
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Affiliation(s)
- Y Huang
- Gladstone Institute of Cardiovascular Disease, University of California, San Francisco, California 94141-9100, USA
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Templeton AR. The complexity of the genotype-phenotype relationship and the limitations of using genetic "markers" at the individual level. SCIENCE IN CONTEXT 1998; 11:373-389. [PMID: 15168668 DOI: 10.1017/s0269889700003082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Many associations have recently been discovered between phenotypic variation and genetic loci, causing some to advocate what Robert Sinsheimer has called "a new eugenics" that would treat genetic "defects" in individuals prone to a disease. The first premise of this vision is that genetic association studies reveal the biological cause of the phenotypic variation. Once the responsible genes are known, the second premise is that we should focus upon changing "nature" rather than "nurture" by correcting the "defective" genes. The first premise is flawed because associations between genetic markers and phenotypes can be spurious, as shown by an example. Moreover, it is shown that using non-causative but associated genetic markers one at a time (the normal practice) can lead to incorrect predictions of disease risk for many individuals. Going from association to causation is a non-trivial step scientifically that has rarely been done in much of the human genetic research. Even when a particular locus does contribute to the phenotypic variation of interest, the first premise remains flawed because phenotypes in general arise from complex interactions among genes and between genes and environments as shown for genes associations with coronary artery disease (CAD). The ability of current molecular genetic tools to "fix" defective genotypes is extremely limited, but even if the technological problems could be overcome, the studies on CAD reveal no obvious "defective" gene to fix because the genetic effects are so context dependent (upon both other genes and environmental factors). Contrary to the second premise of the new eugenics, the more we learn about how different genotypes show variable responses to environments, the more important the environment becomes for individual treatment. The paradigm of a "defective gene" may work for classical Mendelian genetic diseases that are due to loss-of-function mutations. However, such mutations affect only a small portion of humanity. When the focus is changed to common disease and behavioral phenotypes, the "defective gene" paradigm is biologically meaningless and often harmful when applied to individuals. Thus, even when genes clearly do influence common phenotypic variation, the premises of the "new eugenics" are biologically indefensible.
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Sklavounou E, Economou-Petersen E, Karadima G, Panas M, Avramopoulos D, Varsou A, Vassilopoulos D, Petersen MB. Apolipoprotein E polymorphism in the Greek population. Clin Genet 1997; 52:216-8. [PMID: 9383026 DOI: 10.1111/j.1399-0004.1997.tb02550.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The APOE gene is located on chromosome 19, and the three common alleles are designated epsilon2, epsilon3, and epsilon4. The epsilon4 allele is associated with increased plasma cholesterol, atherosclerosis and cardiovascular disease, Alzheimer's disease, and decreased longevity. The objective of the present study was to estimate the distribution of APOE alleles in the Greek population by DNA analysis. The material consisted of 216 voluntary, healthy Greek blood donors (146 males/70 females). The APOE allele frequencies were epsilon2: 5.3%, epsilon3: 88.2%, epsilon4: 6.5%. The epsilon4 allele frequency of 6.5% in the Greek population is, together with the frequency in the Chinese population, among the lowest in the world.
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Affiliation(s)
- E Sklavounou
- Department of Chemistry, University of Athens, Greece
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Abstract
Rapid discoveries of novel and unexpected disease-associated genes for atherosclerotic coronary artery disease (CAD) are anticipated as genomic maps become more detailed and methods for mapping complex disease phenotypes become more refined. Although establishing association or linkage of a marker locus to a CAD susceptibility gene is an important first step, the long-term goal should be to define the underlying functional mutations and explore possible disease mechanisms, including the gene-environment interactions that culminate in clinically apparent disease. This review will define a contemporary research paradigm for study of the genetics of CAD and other common chronic diseases, using the tools of modern molecular biology and human genetics.
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Affiliation(s)
- E Boerwinkle
- Human Genetics Center, University of Texas, Houston, USA
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Boerwinkle E, Ellsworth DL, Hallman DM, Biddinger A. Genetic analysis of atherosclerosis: a research paradigm for the common chronic diseases. Hum Mol Genet 1996; 5 Spec No:1405-10. [PMID: 8875244 DOI: 10.1093/hmg/5.supplement_1.1405] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Rapid discoveries of novel and unexpected disease-associated genes for atherosclerotic coronary artery disease (CAD) are anticipated as genomic maps become more detailed and methods for mapping complex disease phenotypes become more refined. Although establishing association or linkage of a marker locus to a CAD susceptibility gene is an important first step, the long-term goal should be to define the underlying functional mutations and explore possible disease mechanisms, including the gene-environment interactions that culminate in clinically apparent disease. This review will define a contemporary research paradigm for study of the genetics of CAD and other common chronic diseases using the tools of modern molecular biology and human genetics.
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Affiliation(s)
- E Boerwinkle
- Human Genetics Center, University of Texas-Houston Health Science Center, Houston 77225, USA
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