Official publication of Rawalpindi Medical University
The Apolipoprotein E Polymorphism And Dyslipidemia In Elderly Patients Of Calcific Aortic Stenosis

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Afaq E, Nisar MK, Khan AI, Shafiq M, Yousufzai MI ul A, Khan S. The Apolipoprotein E Polymorphism And Dyslipidemia In Elderly Patients Of Calcific Aortic Stenosis: A Case Control study. JRMC [Internet]. 2023 Sep. 26 [cited 2024 May 2];27(3). Available from: https://www.journalrmc.com/index.php/JRMC/article/view/2282

Abstract

Objective: This study aimed to investigate the impact of the Apo E polymorphisms on plasma lipid profile and to identify the polymorphism of the apo-E gene as genetic predictor of calcific AS in Pakistani population.

 

Methodology: This was a case control study conducted in Dow University of Health Sciences and National Institute of Cardiovascular Disease, Karachi. It included total of 100 individuals, 50 echocardiographically identified calcific AS cases and 50 age and gender matched controls. Apo E allele frequencies were computed, lipid profiles were estimated and Apo E gene polymorphism was identified by the techniques of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).

 

Result: Apo E 2, 3, and 4 allele frequencies were 16%, 52%, and 32% in calcific AS cases, and

10%, 52%, 28% in controls respectively (p=0.622). Out of 50 cases, 18% presented with mild AS, 22% moderate AS and 60% lied in severe calcific AS. It was observed that levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) were higher in Apo E4 allele as compared to other genes in both cases and control.

 

Conclusion: The findings of this study suggested that Apo E4 allele of Apo E gene is an impotent risk factors for dyslipidemia while Apo E4 allele is not associated with calcific AS contemplates distinctive genetic backgrounds of CAD and AS.

https://doi.org/10.37939/jrmc.v27i3.2282

References

Zeng YI, Sun R, Li X, Liu M, Chen S, Zhang P. Pathophysiology of valvular heart disease. Experimental and therapeutic medicine. 2016 Apr 1;11(4):1184-8. https://doi.org/10.3892/etm.2016.3048

Grave C, Juillière Y, Tuppin P, Weill A, Gabet A, Tribouilloy C, Olié V. Epidemiological Features of Aortic Stenosis in a French Nationwide Study: 10‐Year Trends and New Challenges. Journal of the American Heart Association. 2020 Dec 1;9(23):e017588. https://doi.org/10.1161/JAHA.120.017588

Baber U, Kini AS, Moreno PR, Sharma SK. Calcific aortic stenosis: pathology and role of balloon aortic valvuloplasty. Intervent Cardiol Clin. 2012;1:1-9. 10.1016/j.iccl.2011.09.001

Conte M, Petraglia L, Campana P, Gerundo G, Caruso A, Grimaldi MG, Russo V, Attena E, Leosco D, Parisi V. The role of inflammation and metabolic risk factors in the pathogenesis of calcific aortic valve stenosis. Aging clinical and experimental research. 2021 Jul;33:1765-70. https://doi.org/10.1007/s40520-020-01681-2

Chen HY, Engert JC, Thanassoulis G. Risk factors for valvular calcification. Current opinion in endocrinology, diabetes, and obesity. 2019 Apr;26(2):96. doi:10.1097/MED.0000000000000471.

Pang J, Abraham A, Vargas-García C, Bates TR, Chan DC, Hooper AJ, Bell DA, Burnett JR, Schultz CJ, Watts GF. An age-matched computed tomography angiographic study of coronary atherosclerotic plaques in patients with familial hypercholesterolaemia. Atherosclerosis. 2020 Apr 1;298:52-7. https://doi.org/10.1016/j.atherosclerosis.2020.03.001

Marais AD. Apolipoprotein E in lipoprotein metabolism, health and cardiovascular disease. Pathology. 2019 Feb 1;51(2):165-76. https://doi.org/10.1016/j.pathol.2018.11.002

Novaro GM, Sachar R, Pearce GL, Sprecher DL, Griffin BP. Association between apolipoprotein E alleles and calcific valvular heart disease. Circulation. 2003 Oct 14;108(15):1804-8. https://doi.org/10.1161/01.CIR.0000097560.96431.3E

Campbell I. Chi‐squared and Fisher–Irwin tests of two‐by‐two tables with small sample recommendations. Statistics in medicine. 2007 Aug 30;26(19):3661-75. https://doi.org/10.1002/sim.2832

McQuillan B. Echocardiography 6th Edition, H. Feigenbaum, WF Armstrong, T. Ryan, Lippincott Williams & Wilkins (2004), 876 pp., Hardcover, RRP $262.90, ISBN 0781731984.

Su X, Peng D. The exchangeable apolipoproteins in lipid metabolism and obesity. Clinica Chimica Acta. 2020 Apr 1;503:128-35. https://doi.org/10.1016/j.cca.2020.01.015

de Oliveira Sá MP, Cavalcanti LR, Perazzo ÁM, Gomes RA, Clavel MA, Pibarot P, Biondi-Zoccai G, Zhigalov K, Weymann A, Ruhparwar A, Lima RC. Calcific aortic valve stenosis and atherosclerotic calcification. Current atherosclerosis reports. 2020 Feb;22:1-6. https://doi.org/10.1007/s11883-020-0821-7

Liu S, Liu J, Weng R, Gu X, Zhong Z. Apolipoprotein E gene polymorphism and the risk of cardiovascular disease and type 2 diabetes. BMC cardiovascular disorders. 2019 Dec;19:1-6. https://doi.org/10.1186/s12872-019-1194-0

Liu Y, Gu Y, Shen Y, Lin B, Li Y, He X, Zhang Y, Lu L, Shen W, Zhang Q, Yang K. Association between serum leptin level and calcific aortic valve disease. Journal of the American Heart Association. 2019 Oct 1;8(19):e012495. https://doi.org/10.1161/JAHA.119.012495

Yi B, Zeng W, Lv L, Hua P. Changing epidemiology of calcific aortic valve disease: 30-year trends of incidence, prevalence, and deaths across 204 countries and territories. Aging (Albany NY). 2021 May 5;13(9):12710. https://doi.org/10.18632%2Faging.202942

Liyanage L, Lee NJ, Cook T, Herrmann HC, Jagasia D, Litt H, Han Y. The impact of gender on cardiovascular system calcification in very elderly patients with severe aortic stenosis. The international journal of cardiovascular imaging. 2016 Jan;32:173-9. https://doi.org/10.1007/s10554-015-0752-5

Hofmanis J, Hofmane D, Svirskis S, Mackevics V, Tretjakovs P, Lejnieks A, Signorelli SS. HDL-C role in acquired aortic valve stenosis patients and its relationship with oxidative stress. Medicina. 2019 Jul 29;55(8):416. https://doi.org/10.3390/medicina55080416

Hofmanis J. Inflammatory and Non-Inflammatory Risk Factors in Acquired Aortic Valve Stenosis. Doctoral Thesis. https://doi.org/10.25143/prom-rsu_2019-07_dt

Carnevale R, Cammisotto V, Pagano F, Nocella C. Effects of smoking on oxidative stress and vascular function. Smoking prevention and cessation. 2018 Nov 5;5. http://dx.doi.org/10.5772/intechopen.78319

Kamstrup PR, Tybjærg-Hansen A, Nordestgaard BG. Elevated lipoprotein (a) and risk of aortic valve stenosis in the general population. Journal of the American College of Cardiology. 2014 Feb 11;63(5):470-7. http://dx.doi.org/10.1016/j.jacc.2013.09.038

Katsi V, Marketou M, Kallistratos MS, Makris T, Manolis AJ, Tousoulis D, Stefanadis C, Vardas P, Kallikazaros I. Aortic valve stenosis and arterial hypertension: a synopsis in 2013. Current hypertension reports. 2013 Aug;15:298-303. https://doi.org/10.1007/s11906-013-0357-0

El Sabbagh A, Nishimura RA. Clinical conundrum of coronary artery disease and aortic valve stenosis. Journal of the American Heart Association. 2017 Feb 20;6(2):e005593. https://doi.org/10.1161/JAHA.117.005593

Ortlepp JR, Pillich M, Mevissen V, Krantz C, Kimmel M, Autschbach R, Langebartels G, Erdmann J, Hoffmann R, Zerres K. APOE alleles are not associated with calcific aortic stenosis. Heart. 2006 Oct 1;92(10):1463-6. http://dx.doi.org/10.1136/hrt.2005.075317

Cenarro A, Etxebarria A, de Castro-Orós I, Stef M, Bea AM, Palacios L, Mateo-Gallego R, Benito-Vicente A, Ostolaza H, Tejedor T, Martín C. The p. Leu167del mutation in APOE gene causes autosomal dominant hypercholesterolemia by down-regulation of LDL receptor expression in hepatocytes. The Journal of Clinical Endocrinology & Metabolism. 2016 May 1;101(5):2113-21. https://doi.org/10.1210/jc.2015-3874

Karjalainen JP, Mononen N, Hutri-Kähönen N, Lehtimäki M, Juonala M, Ala-Korpela M, Kähönen M, Raitakari O, Lehtimäki T. The effect of apolipoprotein E polymorphism on serum metabolome–a population-based 10-year follow-up study. Scientific reports. 2019 Jan 24;9(1):458. http://creativecommons.org/licenses/by/4.0/

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Copyright (c) 2023 Erum Afaq, Muhammad Kashif Nisar, Asif Iqbal Khan, Mamoona Shafiq, Muhammad Irfan ul Akbar Yousufzai, Hira Waseem