Saturated fat intake and alcohol consumption modulate the association between the APOE polymorphism and risk of future coronary heart disease: a nested case-control study in the Spanish EPIC cohort

• Published in: The Journal of nutritional biochemistry Vol. 22; no. 5; pp. 487 - 494
• Main Authors: Corella, Dolores, Portolés, Olga, Arriola, Larraitz, Chirlaque, María Dolores, Barrricarte, Aurelio, Francés, Francesc, Huerta, José María, Larrañaga, Nerea, Martínez, Carmen, Martinez-Camblor, Pablo, Molina, Esther, Navarro, Carmen, Quirós, Jose R, Rodríguez, Laudina, Sánchez, María José, Ros, Emilio, Sala, Nuria, González, Carlos A, Moreno-Iribas, Concepción
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2011; New York, NY: Elsevier Science; Elsevier
• Subjects: Adult; Aged; Alcohol; Alcohol Drinking - adverse effects; Alleles; APOE; Apolipoproteins E - genetics; Apolipoproteins E - metabolism; Biological and medical sciences; blood lipids; Case-Control Studies; cholesterol; Cholesterol, LDL - blood; confidence interval; Coronary Disease - epidemiology; Coronary Disease - genetics; Diet; dietary fat; energy; European Continental Ancestry Group; fat intake; Fatty Acids - administration & dosage; Fatty Acids - adverse effects; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Genotype; Humans; LDL-C; Longitudinal Studies; low density lipoprotein; Male; men; Middle Aged; Multivariate Analysis; myocardial ischemia; Nutrigenetics; Odds Ratio; Polymorphism, Genetic; Regression Analysis; risk; Risk Factors; Saturated fat; Spain - epidemiology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; women; Spain; Alcohol; Nutrigenetics; APOE; Saturated fat; LDL-C; Lipids; Cardiovascular disease; Case control study; Coronary heart disease; Vertebrata; Association; Mammalia; Saturated fatty acid; Apolipoprotein E; Food intake; Risk factor; Polymorphism
• ISSN: 0955-2863; 1873-4847
• DOI: 10.1016/j.jnutbio.2010.04.003

The association is still not clear between the common APOE polymorphism and coronary heart disease (CHD) risk, nor its modulation by diet. Thus, our aim was to study the association between the APOE genotypes and incident CHD and how dietary fat and alcohol consumption modify these effects. We performed a nested case-control study in the Spanish European Prospective Investigation into Cancer and Nutrition cohort. Healthy men and women (41 440, 30-69 years) were followed up over a 10-year period, with the incident CHD cases being identified. We analyzed 534 incident CHD cases and 1123 controls. APOE, dietary intake and plasma lipids were determined at baseline. The APOE polymorphism was significantly associated with low-density lipoprotein cholesterol (LDL-C), and gene-alcohol interactions in determining LDL-C were detected. In the whole population, the E2 allele was significantly associated with a lower CHD risk than E3/E3 subjects [odds ratio (OR), 0.58; 95% confidence interval (CI), 0.38-0.89]. The E4 allele did not reach statistical significance vs. E3/E3 (OR, 1.17; 95% CI, 0.88-1.58). However, saturated fat intake modified the effect of the APOE polymorphism in determining CHD risk. When saturated fat intake was low (<10% of energy), no statistically significant association between the APOE polymorphism and CHD risk was observed (P=.682). However, with higher intake (≥10%), the polymorphism was significant (P=.005), and the differences between E2 and E4 carriers were magnified (OR for E4 vs. E2, 3.33; 95% CI, 1.61-6.90). Alcohol consumption also modified the effect of the APOE on CHD risk. In conclusion, in this Mediterranean population, the E2 allele is associated with lower CHD risk, and this association is modulated by saturated fat and alcohol consumption.