Effect of Atorvastatin and Niacin/LRPT on Apolipoprotein E Distribution, Metabolism and Glycation

Aim: To investigate the influence of apoE genotype on the response to atorvastatin treatment in patients with Type 2 diabetes with nephropathy and the effect of niacin/laropiprant (LRPT) on apoE and glycated apoE concentration and distribution in hyperlipidaemia.Methods: ApoE genotype and the effect of 10mg/day and 80mg/day atorvastatin treatment on apoE concentration were studied in 85 patients with type 2 diabetes with nephropathy. The effect of niacin/LRPT on apoE and glycated apoE was investigated for 36 patients with hyperlipidaemia. Results: After 12 months treatment with atorvastatin, serum apoE concentration decreased significantly in the 80mg/day, but not the 10mg/day group. This decrease was observed in patients with E3 and E4 but not E2 genotype. Hyperlipidaemia did not affect total apoE, but the apoE distribution in HDL and du003e1.21g/ml lipoprotein fractions was significantly lower. Glycated apoE was significantly higher in patients with hyperlipidaemia than healthy volunteers (pu003c0.0001). After 3 months treatment with niacin/LRPT, apoE in apoB?containing lipoproteins (VLDL+LDL) was significantly reduced, but was unchanged in apoA-containing lipoproteins (HDL) compared with treatment with placebo. Niacin/LRPT also had no effect on the elevated glycated apoE observed in patients with hyperlipidaemia.Conclusions: The effect of atorvastatin on total apoE concentration is dependent on the dose of atorvastatin and apoE genotype in patients with type 2 diabetes with nephropathy. Niacin/LRPT has no significant effect on total apoE and glycated apoE, but does influence their distribution in lipoprotein fractions in patients with hyperlipidaemia.