Association Between Apolipoprotein E Gene Polymorphism And Carotid Atherosclerotic Plaque Vulnerability

Objective:To explore the correlation between ApoE gene polymorphism and the stability of carotid atherosclerotic plaques,the discovery of sensitive genotypes contributes to formulating individualized treatment programs for the vulnerable population of carotid atherosclerotic plaques to reduce the occurrence of atherosclerotic cerebral infarction.Method:266 patients defined with CAP by CAU in the first affiliated hospital of Nanchang University were selected from November 2016 to June 2018.The average age of these group was 66.19±10.74.All of these patients were collected without liver function damage,kidney function impairment,metabolic syndrome,endocrine diseases,familial hyperlipidemia and other diseases that affect lipid metabolism.The test results of serum biochemical and ApoE gene were provided by the clinical laboratory of the first affiliated hospital of nanchang university.In the meanwhile,personal clinical variables and personal details were collected,including age,history of hypertension,smoking,diabetes,and,TC,TG,LDL-C,HDL-C,Hcy and so on.According to the carotid artery ultrasound results,266 subjects were divided into control group(non-plaque group,)stable plaque group and unstable plaque group.We analyzed the different frequency distribution of ApoE genotypes and alleles in the above three groups.We also analyzed the differences in blood lipid,Hcy,general conditions.All patients were divided into ?4 and non-?4 groups.We analyzed the differences in age,gender,smoking history,history of hypertension,history of diabetes,total cholesterol,total triglyceride,high-density lipoprotein,low-density lipoprotein and homocysteine.Plaque stability as the dependent variable,and ?4 carriers,age,sex,smoking history,hypertension history,diabetes history,TC,TG,LDL-C,HDL-C,Hcy as the independent variable,binary logistic regression analysis was performed to further analyze the correlation between ApoE gene and carotid plaque stability.Results:1.Among the 266 patients,there were 6 genotypes: ApoE2/2,ApoE2/3,ApoE2/4,ApoE3/3,ApoE3/4,ApoE4/4,accounting for 0.38%,10.53%,1.88%,74.06%,10.53% and 2.63%,respectively.The proportions of three kinds of alleles(?2,?3 and ?4)were 6.58%,84.59% and 8.84%.Thus the ApoE3/3 genotype and the ?3 alleles were the most common.2.In the non-plaque,stable and unstable plaque groups,TC,TG,LDL-C,and Hcy in the plaque group were higher than those in the control group,and HDL-C was lower than those in the control group(P<0.05);age,history of hypertension and history of diabetes were all risk factors for plaque formation,P<0.05.The presence or absence of plaque was independent of gender,P>0.05.In stable and unstable plaques groups,LDL-C and Hcy were higher in the unstable plaque group than in the stable plaque group,and the HDL-C in the unstable plaque group was lower than the stable plaque group,and P<0.05.Age,history of hypertension,and history of diabetes mellitus were risk factors for unstable plaque formation(P<0.05).Plaque stability was independent of gender P>0.05.3.In the E4 and non-E4 groups,TC,TG and LDL-C were higher than those in the control group,and P<0.05,which was statistically significant.HDL-C was lower than that of non-E4 group,P<0.05,with statistical difference.There was no significant difference on Hcy between ?4 allele carriers and non-?4 allele carriers.Compared with non-E4 carriers,the prevalence of hypertension and diabetes among E4 carriers was higher(P<0.05),which is statistically significant.In the groups,it was not related to smoking,P>0.05.4.The binary Logistic regression analysis indicated that the stability of the plaques is associated with the E4,history of hypertension,diabetes,high homocysteine,and P < 0.05.Conclusion:1.ApoE gene possessed polymorphism.ApoE3/3 genotype and ?3 allele were the most common.2.There was a correlation between E4 carriers and plaque stability,and ApoE4 carriers increased the risk of unstable plaque.3.E4 carriers had an effect on blood lipid levels.E4 carriers could increase TC,TG,LDL-C and E4 carriers could reduce HDL-C.