Dietary Treatment of Hypercholesterolaemia: Lack of Relationship between Individual Response and Genetic Variation at the Lipase Loci

The individual benefits of dietary therapy for hyperlipidaemia are known to be unpredictable. Variants at the lipoprotein lipase gene have been shown to associate with atherogenic lipoprotein phenotypes and the delayed clearance of triglyceride-rich lipoproteins. Together with variants of the closely homologous hepatic lipase gene, these may influence the extent of amelioration of plasma lipoprotein concentrations seen in dyslipidaemic patients treated with a low saturates/low cholesterol diet. We correlated the lipid changes seen following an 8-week diet in 83 subjects with primary hypercholesterolaemia (fasting plasma cholesterol > 6.5 mmol/L) with alleles of three restriction polymorphisms (LPL-Hind III and Pvu II; HL-Msp I). Although dietary changes produced a significant improvement in fasting lipids [total cholesterol falling by 5.2% (range -27.9% to +24.3%) and low-density lipoprotein cholesterol reduced by 6.0% (-30.5% to +29.3%)], no significant difference in response between different genotypes could be detected.