Genetic risk score in patients with the APOE2/E2 genotype as a predictor of familial dysbetalipoproteinemia

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Authors

SATNY Martin TODOROVOVA Veronika ALTSCHMIEDOVA Tereza HUBACEK Jaroslav A DLOUHA Lucie LANSKA Vera SOŠKA Vladimír KYSELÁK Ondřej FREIBERGER Tomáš BOBÁK Martin VRABLIK Michal

Year of publication 2024
Type Article in Periodical
Magazine / Source Journal of Clinical Lipidology
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.sciencedirect.com/science/article/pii/S1933287423003422?via%3Dihub
Doi http://dx.doi.org/10.1016/j.jacl.2023.11.010
Keywords Familial dysbetalipoproteinemia; Cardiovascular risk; Polymorphism; Genetic risk score
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Description Background Familial dysbetalipoproteinemia (FD) is an autosomal recessive (rarely dominant) inherited disorder that is almost exclusively associated with the apolipoprotein E gene (APOE) variability. Nonetheless, only a small proportion of APOE2/E2 subjects develop the phenotype for mixed dyslipidemia; the context of other trigger metabolic or genetic factors remains unknown. Methods One hundred and one patients with FD and eighty controls (all APOE2/E2 homozygotes; rs429358) were screened for 18 single-nucleotide polymorphisms (SNPs) within the genes involved in triglyceride metabolism. Results Two SNPs were significantly associated with the FD phenotype (rs439401 within APOE; P < 0.0005 and rs964184 within ZPR1/APOA5/A4/C3/A1 gene cluster; P < 0.0001). Unweighted genetic risk scores - from these two SNPs (GRS2), and, also, additional 13 SNPs with P-value below 0.9 (GRS15) - were created as an additional tool to improve the risk estimation of FD development in subjects with the APOE2/E2 genotype. Both GRS2 and GRS15 were significantly (P < 0.0001) increased in patients and both GRSs discriminated almost identically between the groups (P = 0.86). Subjects with an unweighted GRS2 of three or more had an almost four-fold higher risk of FD development than other individuals (OR 3.58, CI: 1.78–7.18, P < 0.0005). Conclusions We identified several SNPs that are individual additive factors influencing FD development. The use of unweighted GRS2 is a simple and clinically relevant tool that further improves the prediction of FD in APOE2/E2 homozygotes with corresponding biochemical characteristics.
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