Apolipoprotein E genetic variants interact with Mediterranean diet to modulate postprandial hypertriglyceridemia in coronary heart disease patients: CORDIOPREV study

Authors: GOMEZ-DELGADO, FRANCISCO - Universidad De Cordoba; ALCALA-DIAZ, JUAN - Universidad De Cordoba; LEON-ACUNA, ANA - Universidad De Cordoba; LOPEZ-MORENO, JAVIER - Universidad De Cordoba; DELGADO-LISTA, JAVIER - Universidad De Cordoba; GOMEZ-MARIN, BEATRIZ - Universidad De Cordoba; RONCERO-RAMOS, IRENE - Universidad De Cordoba; YUBERO-SERRANO, ELENA - Universidad De Cordoba; RANGEL-ZUNIGA, ORIOL - Universidad De Cordoba; VALS-DELGADO, CRISTINA - Universidad De Cordoba; LUQUE, RAUL - Instituto De Salud Carlos Iii; ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LOPEZ-MIRANDA, JOSE - Universidad De Cordoba; PEREZ-MARTINEZ, PABLO - Universidad De Cordoba

Submitted to: European Journal of Clinical Investigation
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/3/2019
Publication Date: 7/1/2019
Citation: Gomez-Delgado, F., Alcala-Diaz, J.F., Leon-Acuna, A., Lopez-Moreno, J., Delgado-Lista, J., Gomez-Marin, B., Roncero-Ramos, I., Yubero-Serrano, E.M., Rangel-Zuniga, O.A., Vals-Delgado, C., Luque, R.M., Ordovas, J.M., Lopez-Miranda, J., Perez-Martinez, P. 2019. Apolipoprotein E genetic variants interact with Mediterranean diet to modulate postprandial hypertriglyceridemia in coronary heart disease patients: CORDIOPREV study. European Journal of Clinical Investigation. https://doi.org/10.1111/eci.13146.
DOI: https://doi.org/10.1111/eci.13146

Interpretive Summary: After consuming a fat-rich meal, there is an increase in the blood levels of the so-called triglyceride-rich lipoproteins (TRLs). However, there are dramatic interindividual differences in response. Prolonged elevated blood levels of these lipoproteins are considered a risk factor for cardiovascular disease. Our objective was to explore whether long term consumption of two healthy nutritional patterns (low fat [LF] diet or Mediterranean diet [MedDiet]) interacts with variation at a gene known as apolipoprotein E (APOE) to modulate the elevation of TRLs. This gene has been previously associated with several age-related diseases. We selected patients from the CORDIOPREV study who underwent an oral fat load test at baseline and after 3 years of follow-up. After 3 years of follow up, we found a gene-diet interaction between the APOE gene and MedDiet. Specifically, carriers of the T form of the gene showed a more significant decrease in TRLs if they were consuming a Mediterranean diet as compared with CC subjects. In summary, long-term consumption of a Mediterranean diet modulated postprandial TRL according to their APOE genetic variation in these CHD patients. This gene-diet interaction may contribute to more accurate dietary advice.

Technical Abstract: Background: We try to explore whether long term consumption of two healthy dietary patterns (low fat [LF] diet or Mediterranean diet [MedDiet]) interacts with the apolipoprotein E (APOE) single nucleotide polymorphisms (SNPs: rs439401, rs440446 and rs7412) modulating postprandial hypertriglyceridemia (ppHTG) in coronary heart disease (CHD) patients. Methods and Results: We selected patients from the CORDIOPREV study with genotyping and who underwent an oral fat load test (FLT) at baseline and after 3 years follow-up (n = 506). After 3 years of follow-up, we found a gene-diet interaction between the APOE rs439401 SNP and MedDiet. Specifically, T-allele carriers in the MedDiet group showed a more significant decrease in postprandial triglycerides (TG: P = 0.03) and large triacylglycerol-rich lipoproteins (TRLs) TG (large TRLs TG; P = 0.01) compared with CC subjects. Consistently, the area under the curve of TG (AUC-TG; P-interaction = 0.03) and AUC-large TRLs TG (P-interaction = 0.02) were significantly lower in T-allele carriers compared with CC subjects.