ApoE Genotype, Lipid Profile, Exercise, and the Associations With Cardiovascular Morbidity and 18-Year Mortality
ApoE Genotype, Lipid Profile, Exercise, and the Associations With Cardiovascular Morbidity and 18-Year Mortality
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DOI：
10.1093/gerona/glz232
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发表时间：
2020-10-01
影响因子：
5.1
通讯作者：
Chetrit, Angela
中科院分区：
文献类型：
--
作者：
Dankner, Rachel;Ben Avraham, Sivan;Chetrit, Angela
背景资料：长寿研究检测了载脂蛋白E（ApoE），这是一种参与脂蛋白代谢的基因，与年龄相关疾病的易感性和死亡率相互作用。我们评估了ApoE亚型与心血管疾病（CVD）和全因mortals.Methods：一个前瞻性队列的949名幸存者的以色列研究葡萄糖耐量，肥胖和高血压，在1999年至2004年，平均年龄72岁，死亡率，直到2017年。参与者接受了生活习惯和病史的采访。进行人体测量学和生化指标测定。结果：本组人群中ApoE E3基因型最多（76.3%），E2和E4基因型各占11.2%和12.5%。仅在男性中，ApoE E4与CVD相关（校正比值比= 1.46，95%置信区间[CI] 0.76，2.80）和18年死亡率（校正风险比= 1.47，95% CI 0.95，2.26），校正年龄、种族、体力活动、高血压、糖尿病、低密度脂蛋白（LDL）-胆固醇，高密度脂蛋白（HDL）胆固醇、甘油三酯和降脂药物。经ApoE和上述变量校正的低水平HDL胆固醇与CVD（校正比值比= 1.35，95% CI 1.00，1.83）和全因死亡率（校正风险比= 1.42，95% CI 1.14，1.78）的患病率较高相关。与久坐者相比，ApoE E3和E2使体力活动者的18年死亡风险降低（校正的风险比= 0.57，95% CI 0.44，0.74，校正的风险比= 0.53，95% CI 0.78，1.02）。在社区居住的老年人中，社会人口学特征和体力活动、血压和HDL-胆固醇水平可能超过ApoE多态性对CVD发病率和全因死亡率的影响。
Background: Studies of longevity examined apolipoprotein E (ApoE), a gene involved in lipoprotein metabolism, which interacts with susceptibility to age-related diseases, and with mortality. We evaluated the association of ApoE isoforms with cardiovascular disease (CVD) and all-cause mortality.Methods: A prospective cohort of 949 survivors of the Israel Study of Glucose Intolerance, Obesity, and Hypertension, examined during 1999-2004, mean age 72 years, was followed for mortality until 2017. Participants were interviewed for lifestyle habits and medical history. Anthropometrics and biochemical markers were taken. Logistic regression was used to assess CVD morbidity and Cox proportional hazard model for mortality.Results: The most common genotype in the cohort was ApoE E3 (76.3%), with the other two almost equally distributed (ApoE E2 11.2% and ApoE E4 12.5%). In men only, ApoE E4 associated with CVD (adjusted odds ratio = 1.46, 95% confidence interval [CI] 0.76, 2.80) and with 18-year mortality (adjusted hazard ratio = 1.47, 95% CI 0.95, 2.26), adjusting for age, ethnicity, physical activity, hypertension, diabetes, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides and lipid-lowering medications. Low levels of HDL cholesterol, adjusted for ApoE and the above-mentioned variables, associated with higher prevalence of CVD (adjusted odds ratio = 1.35, 95% CI 1.00, 1.83) and all-cause mortality (adjusted hazard ratio = 1.42, 95% CI 1.14, 1.78). ApoE E3 and E2 conferred a lower 18-year mortality risk in the physically active individuals, compared to the sedentary (adjusted hazard ratio = 0.57, 95% CI 0.44, 0.74, and adjusted hazard ratio = 0.53, 95% CI 0.78, 1.02, respectively).Conclusions: In community-dwelling older adults, sociodemographic characteristics and physical activity, blood pressure and HDL-cholesterol levels, may outweigh the impact of ApoE polymorphisms on CVD morbidity and all-cause mortality.