载脂蛋白E基因多态性对冠心病患者餐后甘油三酯代谢的影响

Influence of apolipoprotein E polymorphism on postprandial triglyceride metabolism in patients with coronary heart disease

目的 探讨载脂蛋白 (Apo)E基因多态性对冠心病患者高脂餐后甘油三酯 (TG)代谢的影响。方法 82例冠心病患者禁食 12h后接受高脂餐负荷试验。测定空腹和餐后 2、4、5、7h血清TG浓度。采用聚合酶链反应 (PCR)检测ApoE基因型。结果 82例冠心病患者餐后 2、4、5、7h血清TG水平显著升高 (P <0 0 5 )。相关分析表明 :空腹TG水平与TG曲线下面积 (TG AUC)显著正相关 (r=0 4 36 ,P <0 0 5 )。ApoE 3/3(n =36 )、ApoE 3/4(n =2 5 )和ApoE2 /3(n =2 1)基因型患者的空腹血清TG水平差异无显著性。ε2和ε4携带者餐后血清TG水平以及TG AUC显著高于ε3/ε3携带者。结论 ApoE基因多态性影响冠心病患者餐后甘油三酯代谢。ε2和ε4等位基因与餐后富含甘油三酯脂蛋白代谢异常有关。

Objective To explore the influence of apolipoprotein E polymorphism on postprandial triglyceride metabolism in patients with coronary heart disease (CHD) after a high-fat meal (800 calorie; 50 g fat ).Methods Eighty-two CHD patients were studied.The serum concentrations of triglyceride in fasting and at 2, 4, 5, 7 hours after a single high-fat meal were measured.Apolipoprotein E genotypes were assessed by polymerase chain reaction.Results The postprandial serum triglyceride concentrations increased significantly at 2-7 hours compared with that in fasting in 82 CHD patients (P<0.05).On the correlation analysis, the fasting triglyceride concentration positively correlated with the TG area under the concentration curve (TG-AUC)over 7 hours after the high-fat meal(r=0.436,P<0.05).There were no significant differences in fasting serum triglyceride and high-density lipoprotein cholesterol concentrations among the patients with ApoE3/3(n=36), ApoE3/4(n=25)and ApoE2/3(n=21)genotypes.The ε3/ε4 carriers had higher total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations while the ε2/ε3 carriers had lower TC and LDL-C concentrations than the ε3/ε3 carriers (P<0.05).The postprandial serum triglyceride concentrations at all time points in ε2/ε3 carriers and at 2, 4 and 5 hours in the ε3/ε4 carriers were higher than those in the ε3/ε3 carriers who had lower TG-AUC than the ε2/ε3 and ε3/ε4 carriers (P<0.05).Conclusions ε2 and ε4 alleles may be related to abnormal clearance of triglyceride-rich lipoproteins.Apolipoprotein E polymorphism could influence postprandial triglyceride metabolism in patients with coronary heart disease.