Effects of apolipoprotein E and solute carrier organic anion transporter family member 1B1 gene polymorphisms on statin efficacy and safety in dyslipidemic patients

Objective To investigate the distribution of the apolipoprotein E ( ApoE ) and solute carrier organic anion transporter family member 1B1 ( SLCO1B1 ) polymorphisms in dyslipidemia patients and their impact on statin efficacy and safety. Methods A retrospective analysis was conducted on dyslipidemic inpatients (April 2024–March 2025) who received statin therapy and genetic testing for SLCO1B1 (rs4149056) and ApoE (rs429358 and rs7412), to analyze the association of genotypes with lipid levels and safety indicators. Results The final analysis included 238 hospitalized patients with dyslipidemia (156 males and 82 females) who met the inclusion criteria. The study population had a mean age of 60.61 ± 0.91 years (mean ± SEM). The allele frequencies for both ApoE and SLCO1B1 polymorphisms were in Hardy–Weinberg equilibrium ( P > 0.05). Analysis of statin efficacy revealed a significant association between ApoE genotype and atorvastatin response: E3 carriers demonstrated higher low-density lipoprotein cholesterol levels posttreatment compared to E2 carriers (2.85 ± 1.00 mmol/l vs. 2.28 ± 0.96 mmol/l, P = 0.026). However, no such association was found in patients administered rosuvastatin. For safety outcomes, comparisons of creatine kinase and alanine aminotransferase levels between carriers of the SLCO1B1 TC and TT genotypes showed no statistically significant differences. Conclusion APOE polymorphisms influence statin efficacy. The E2 genotype is associated with better atorvastatin efficacy in lipid management. At low-to-moderate doses, the SLCO1B1 TC genotype did not increase safety risk, supporting its clinical safety.