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Originally published In Press as doi:10.1194/jlr.M600288-JLR200 on August 3, 2006

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Journal of Lipid Research, Vol. 47, 2475-2481, November 2006
Copyright © 2006 by American Society for Biochemistry and Molecular Biology

Protective effect of apolipoprotein E2 on coronary artery disease in African Americans is mediated through lipoprotein cholesterol

Erdembileg Anuurad*, Jill Rubin{dagger}, Guijing Lu*, Thomas A. Pearson§, Steve Holleran**, Rajasekhar Ramakrishnan** and Lars Berglund1,*,{dagger}{dagger}

* Department of Medicine, University of California, Davis, CA
{dagger} Department of Medicine, Columbia University, New York, NY
§ Department of Family and Community Medicine, University of Rochester, Rochester, NY
** Department of Pediatrics, Columbia University, New York, NY
{dagger}{dagger} Department of Veterans Affairs Northern California Health Care System, Davis, CA

Published, JLR Papers in Press, August 3, 2006.

1 To whom correspondence should be addressed. e-mail: lars.berglund{at}ucdmc.ucdavis.edu

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.

Supplementary key words coronary heart disease • polymorphism • cardiovascular risk factors • genetics


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