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Annals of Clinical & Laboratory Science 32:50-54 (2002)
© 2002 Association of Clinical Scientists

HDL Cholesterol Levels in Patients with Molecularly Defined Familial Hypercholesterolemia

George Miltiadous1, Marios A. Cariolou2 and Moses Elisaf1
1 Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
2 Molecular Genetics Department,The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus

Address correspondence to Moses Elisaf, M.D., F.R.S.H., Department of Internal Medicine, Medical School, University of Ioannina, GR 451 10, Ioannina, Greece; tel 306 519 7509; fax 306 514 5944; e-mail me00521{at}cc.uoi.gr.

Familial hypercholesterolemia (FH) is the most common genetic disorder leading to premature atherosclerosis. Typically, it is due to mutations in the LDL receptor gene resulting in elevated total and LDL cholesterol levels. The type of the LDL receptor gene mutations may affect the severity of hypercholesterolemia and consequently the incidence of coronary atherosclerosis. Furthermore, high-density lipoprotein (HDL) cholesterol levels have been recently shown to be an independent risk factor for coronary heart disease in this population. We examined the effect of the type of the LDL receptor gene mutations and of common gene polymorphisms possibly affecting HDL metabolism [cholesterol ester transfer protein (CETP), apolipoprotein A-IV (ApoA-IV), angiotensin converting enzyme (ACE), and apolipoprotein E (ApoE)] on HDL cholesterol levels in patients with molecularly defined heterozygous FH who were attending our lipid clinic (n=84). The nature of the LDL receptor gene mutation (81T>G, n=12; 858C>A, n=13; 1285G>A, n=12; 1646G>A, n=22; and 1775G>A, n=25) did not significantly influence HDL cholesterol levels. Unlike other gene polymorphisms, the apolipoprotein (apo) E gene polymorphism did significantly affect these levels. In fact, the presence of the E4 allele was associated with lower HDL cholesterol levels compared to patients not carrying this allele. We conclude that HDL cholesterol levels in heterozygous FH patients may be affected by the apoE gene polymorphism.

Keywords: HDL cholesterol, familial hypercholesterolemia, apoE genotype, CETP gene polymorphism, apoA-IV gene polymorphism, ACE gene polymorphism







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