Garcia · eLife 2021 · cross-sectional observational study · n=1266

APOE4 is associated with elevated blood lipids and lower levels of innate immune biomarkers in a tropical Amerindian subsistence population.

Cited 59 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional observational study of genetic associations and biomarkers

PubMed 34586066 · doi:10.7554/eLife.68231 · record verified 2026-08-31

What was done

Investigated the association between the APOE4 genetic variant, blood lipid concentrations (total cholesterol, LDL, and oxidized LDL), and inflammatory biomarkers (including C-reactive protein) among 1,266 Indigenous Tsimane forager-farmers (50% female) across 80 villages in Bolivia living in an active subsistence context with high pathogen exposure.

What was found

APOE4 was associated with 30% lower C-reactive protein (CRP) and higher total cholesterol and oxidized LDL. Blood lipids showed no association or an inverse association with inflammatory biomarkers, except for oxidized LDL and inflammation in obese adults. Furthermore, APOE4 carriers maintained elevated total and LDL cholesterol even at low body mass indices (BMIs).

Why it matters

These results provide evidence that the metabolic and inflammatory phenotype linked to APOE4 differs between post-industrial societies and high-pathogen subsistence environments, supporting an evolutionary mismatch model where APOE4-driven lipid elevation may support immune function rather than promote cardiovascular disease.

Limits

The study design is cross-sectional and observational, preventing causal inference. Measurements were confined to a single Indigenous population (Tsimane), and the abstract does not report longitudinal cardiovascular or infection endpoints.

Cited by