Overweight modulates APOE and APOA5 alleles on the risk of severe hypertriglyceridemia

Background: This study aimed to investigate whether the body mass index (BMI) in combination with genetic variations in APOE and APOA5_T alleles modulates the risk of sHTG. Methods: There were 255 moderate HTG (TG >= 2.26 and <5.65 mmol/L) and 176 sHTG (TG >= 5.65 mmol/L) and 304 controls (TG<2.26 mmol/L) were recruited. APOE epsilon alleles were genotyped using sequence-specific primers; the APOA5_T allele (c.553G>T, rs2075291) was identified using a restriction site polymorphism. Overweight/obesity was defined as BMI >= 25 kg/m(2) and non-overweight as BMI<25 kg/m(2). Results: Multivariate logistic regression analysis showed, in addition to APOA5_T allele, a significant interaction between BMI >= 25 kg/m(2) and APOE4 carriers on the risk of sHTG. Subjects with diagnosis of diabetes, current smoking, hypertension, levels of non-high density lipoprotein, and BMI >= 25 kg/m(2) were significant determinants of sHTG. The odds ratio (95% confidence intervals) of overweight/obese APOE4 carriers for sHTG was 13.56 (4.89-37.59) more than those of non-overweight non-APOE4 carriers, while the odds ratio for sHTG in overweight/obese patients with the APOA5_T allele was 15.83 (7.77-32.26) higher than those of non-overweight non-APOA5 carriers. Conclusions: Overweight/obesity may potentiate the genetic variants of the APOE4 and APOA5_T alleles on the risk of sHTG. (C) 2012 Elsevier B.V. All rights reserved.