PubMed · 1671428
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1991-02-16. Lipoprotein (a). https://pubmed.ncbi.nlm.nih.gov/1671428/
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Apolipoprotein B (apoB) is the sole protein component of low-density lipoprotein (LDL) and is thought to play an important role in atherogenesis. We performed a meta-analysis of the associations between the three most frequently investigated polymorphisms (XbaI, signal peptide insertion/deletion, EcoRI) in the apolipoprotein B (APOB) gene, lipid parameters, and the risk of ischemic heart disease (IHD). We restricted our analysis to Caucasians. Homozygotes for the XbaI X+ allele had significantly elevated levels of LDL cholesterol (LDL-C) and apoB, but a decreased risk (OR=0.80; 95%CI: 0.66-0.96) of IHD. Homozygosity for the signal peptide deletion allele was associated with similarly increased levels of LDL-C and apoB, and with an increased risk of IHD (OR=1.30; 95%CI: 1.08-1.58). Subjects homozygous for the rare EcoRI allele had significantly decreased levels of total and LDL cholesterol, but unaltered risk of IHD. We conclude that all three polymorphic apoB sites are associated with altered lipid levels, but not necessarily with a consistently altered risk of IHD. These data suggest that the relationship between apoB levels, hypercholesterolemia and IHD risk cannot have a simple molecular basis in the apoB gene.
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Atherosclerosis is a multifactorial disorder in which lipid profiles play an important role. In addition to the conventional lipid parameters such as total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, there is an increasing interest in plasma apolipoprotein B (apoB) for risk stratification in daily practice. ApoB is the structural protein of all atherogenic lipoproteins. Each of these lipoproteins contains one apoB molecule and therefore the apoB concentration is a direct reflection of the number of atherogenic particles in the blood. Some patients have a reasonably normal lipid spectrum but an elevated concentration of apoB, which is associated with an increased risk for atherosclerotic complications. This is especially the case for patients with atherogenic forms of hypertriglyceridaemia and with insulin resistance syndrome. On the basis of epidemiological data, it appears that apoB not only has added value as a risk parameter but also as a treatment target. However the clinical use of apoB levels requires a standardised method with better-defined reference values, as is already the case for total-cholesterol and LDL-cholesterol levels.