Apolipoprotein E in Apolipoprotein B (apo B)- and Non-apo B-containing Lipoproteins in 3523 Participants in the Stanislas Cohort: Biological Variation and Genotype-specific Reference Limits

BACKGROUND: Apolipoprotein (apo) E is a component of two major classes of plasma lipoproteins, apo B- (apo E-LpB) and non-apo B-containing (apo E-Lp-non-B) lipoproteins. The factors that affect total apo E in particles [lipoprotein E (LpE), apo E-Lp-non-B, and apo E-LpB], are incompletely characterized. METHODS: We studied the determinants of these lipoparticles in a sample population of presumably healthy individuals: 1784 children (age range, 8-18 years) and 1739 adults (age range, 19-50 years). Serum concentrations of LpE and apo E-Lp-non-B were measured by electroimmunoassays, and the concentration of apo E-LpB was calculated by a difference method. RESULTS: Serum LpE and apo E-Lp-non-B were higher in females than in males. Their concentrations decreased with age until 20-25 years and then increased in men but not in women. apo E-LpB concentrations increased up to 20-25 years and were similar in both sexes. Thereafter, adult men had higher values than women. Individuals carrying the epsilon2 allele had higher mean apo E-Lp-non-B concentrations and lower apo E-LpB concentrations than did individuals carrying the epsilon3 allele. Individuals with the epsilon4 allele showed an inverse profile compared with those with the epsilon2 allele. Age, gender, the common apo E polymorphism, puberty, serum lipid concentrations, and alcohol consumption were significantly associated with total LpE, apo E-Lp-non-B, and apo E-LpB concentrations. Reference limits were established according to age, gender, and the common apo E polymorphism. CONCLUSIONS: Because measurements of LpE, apo E-Lp-non-B, and apo E-LpB concentrations may improve cardiovascular risk assessment, the proposed reference limits will aid interpretation of the results in clinical or therapeutic trials.