Effect of apolipoprotein E genotype and saturated fat intake on plasma lipids and myocardial infarction in the Central Valley of Costa Rica.
Level 4 - case-series / case-control
Matched case-control study
PubMed 18494374 · doi:10.1353/hub.2008.0010
What was done
Researchers evaluated the interaction between APOE polymorphisms (-491 A/T, APOE*4 [C112R], and APOE*2 [R158C]) and saturated fat intake on plasma lipid levels and myocardial infarction risk. The study analyzed 1,927 myocardial infarction cases and 1,927 population-based controls matched for age, sex, and residence in the Central Valley of Costa Rica.
What was found
A significant gene-diet interaction was observed (p = 0.0157). High saturated fat intake was associated with higher myocardial infarction risk among wildtype subjects (OR = 1.49; 95% CI, 1.16-1.92), with higher risk among carriers of APOE*2 (OR = 3.17; 95% CI, 1.58-6.36) and carriers of both -491T and APOE*4 (OR = 2.59; 95% CI, 1.38-4.87). A high-fat diet resulted in larger increases in LDL cholesterol among carriers of APOE*2 (+17%) and APOE*4 (+14%) compared to noncarriers (+6%). APOE*4 homozygotes were at elevated risk of myocardial infarction compared to noncarriers (OR = 2.26; 95% CI, 1.03-4.98).
Why it matters
This study shows that APOE genotype modifies the adverse cardiovascular and lipid responses to saturated fat intake, offering an explanation for inconsistent associations between APOE variants and myocardial infarction across populations.
Limits
The retrospective case-control design cannot prove causality and is prone to recall bias in dietary measurement. The study was conducted in a single geographic population, and specific dietary cutoff thresholds were not detailed in the abstract.
Cited by
- supports Saturated fat intake raises atherogenic lipoprotein levels in individuals possessing specific genetic susceptibilities.