Influence of apolipoprotein E polymorphism on serum lipid and lipoprotein changes:: a 21-year follow-up study from childhood to adulthood.: The Cardiovascular Risk in Young Finns Study

Background: We examined the influence of apolipoprotein E (apoE) polymorphism on longitudinal changes in serum lipids by following the subjects participating in The Cardiovascular Risk in Young Finns Study over a 21-year period. Methods: Serum lipids were determined in randomly selected Finnish children and adolescents in 1980 and the subjects were re-examined in 1983, 1986 and after 21 years in 2001. ApoE polymorphism was determined in 1736 participants, and serum lipid values and apoE phenotypes were available for 1233 subjects. Results: ApoE phenotype-related differences in serum total and low-density lipoprotein (LDL)-cholesterol were maintained throughout the 21-year follow-up from childhood to adulthood, i.e., the apoE epsilon 2 allele was consistently associated with lower and the epsilon 4 allele with higher total and LDL-cholesterol (p < 0.001 for all). In adulthood, there was also a significant apoE phenotype-related difference in high-density lipoprotein (HDL)-cholesterol (p=0.007), and the e2 allele was associated with higher and the epsilon 4 allele with lower apoA-I and HDL-cholesterol. In addition, apoB increased in the phenotype order E3/2 < E3/3 < E4 (E4/3 + E4/4) (p < 0.001). The LDL-lowering effect of the epsilon 2 allele was greater in adulthood than in childhood, i.e., there was a significant apoE phenotype x time interaction (p 0.039) with longitudinal change in LDL-cholesterol. Conclusions: ApoE polymorphism is associated with lipid levels at different ages and affects the longitudinal change in LDL-cholesterol from childhood to adulthood.