Korean Journal of Nephrology 1998;17(5):762-770.

지속성 외래 복막투석 환자에서 아포지단백 E 다형성이 죽상경화성 심혈관계 질환 발병에 미치는 영향 (Influence of Apolipoprotein E Polymorphism into Alteration of Atherosclerotic Cardiovascular Disease in CAPD Patients)

이종수, 강재영, 김영일, 양원석, 박수길, 이상구, 채동완, 신영태, 박정식 (Jong Soo Lee, Jae Yeong Kang, Young Il Kim, Won Seok Yang, Dong Wan Chae, Young Tai Shin and Jung Sik Park)

Abstract

Specific apolipoprotein(apo) E genotype has been suggested as a risk factor for atherosclerosis in the general population. Lipid metabolism is known to be modulated by apo E genotype. In this study, we measured apo E genotype, lipoprotein(a)[Lp(a)], apo A phenotype and other lipoproteins in 50 CAPD patients, and evaluated the association of lipid parameters with atherosclerotic cardiovascular disease. Dipyridamole thallium scan with SPECT and ankle- arm blood pressure index(AABI) were performed in all the subjects. The patients who had positive finding in at least one of the two test were considered to have atherosclerotic cardiovascular disease [CVD(＋)]. Fifteen patients had evidence of cardiovascular disease. Serum Lp(a) concentration(median; interquartile range) of CVD(＋) patients(n=15, 62.0 mg/dl; 29.5－82.3) was not different from that of CVD(－) patients(n=35, 65.1mg/dl; 34.3－89.9). The frequency distribution of apo(a) phenotype of CVD (＋) patients did not differ from that of CVD(－) patients. In addition, there were no differences of other lipoproteins levels and lipid profiles between two group. However, significant difference in the frequency distribution of apo E genotype(E2; 6.7 vs 20%, E3; 40 vs 68.6%, E4; 53.3 vs between CVD(＋) and CVD(－) patients. After stratifying the subjects according to the apo E genotype, we observed no difference of lipid profiles, apolipoproteins and Lp(a) concentration in E2, E3, E4. Multivariate regression analysis of risk factors for CVD revealed age and the presence of apo E4 phenotype as independent risk factors of atherosclerotic cardiovascular disease. In conclusion, Apo E4 genotype could be an independent risk factor of atherosclerotic cardiovascular disease in CAPD patients.