Effect of ApoE epsilon 4 gene polymorphism on the correlation between serum uric acid and left ventricular hypertrophy remodeling in patients with coronary heart disease

BackgroundHyperuricemia and dyslipidemia are associated with left ventricular hypertrophy (LVH), while the effect of ApoE gene polymorphism on the correlation between serum uric acid (UA) level and severity of LVH in patients with coronary heart disease (CHD) has not been clarified. MethodsThis was a retrospective observational study of patients with CHD. Patients were divided into groups of epsilon 4 carriers and non-epsilon 4 carriers based on sanger sequencing. The association of ApoE epsilon 4 gene polymorphism, serum UA level, and LVH, determined by cardiac color Doppler ultrasound, was evaluated by multivariate analysis. ResultsA total of 989 CHD patients who underwent ApoE genotyping were enrolled and analyzed. Among them, the frequency of the ApoE epsilon 4 genotype was 17.9% (15.7% for E3/4, 1.1% for E4/4, and 1.1% for E2/4). There were 159 patients with LVH, 262 with end-diastolic LV internal diameter (LVEDD) enlargement, 160 with left ventricular ejection fraction (LVEF) reduction, and 154 with heart failure. Multivariate analysis showed that for every increase of 10 mu mol/L in serum UA level, the risk of LVH decreased in epsilon 4 carriers (odds ratio (OR) = 0.94, 95% confidence interval (CI): 0.890-0.992, P = 0.025) and increased in non-epsilon 4 carriers (OR = 1.03, 95% CI: 1.005-1.049, P = 0.016). The risk of LVEDD enlargement tended to decrease in epsilon 4 carriers (OR = 0.98, 95% CI: 0.943-1.023, P = 0.391) and increased in non-epsilon 4 carriers (OR = 1.03, 95% CI: 1.009-1.048, P = 0.003). The risk of LVEF reduction was reduced in epsilon 4 carriers (OR = 0.996, 95% CI: 0.949-1.046, P = 0.872) and increased in non-epsilon 4 carriers (OR = 1.02, 95% CI: 0.994-1.037, P = 0.17). The risk of LVEDD enlargement decreased in epsilon 4 carriers (OR = 0.98, 95% CI: 0.931-1.036, P = 0.508) and increased in non-epsilon 4 carriers (OR = 1.02, 95% CI: 0.998-1.042, P = 0.07). ConclusionHigh serum UA levels decreased the risk of LVH in ApoE epsilon 4 carriers with CHD, while increased the risk of LVH in non-epsilon 4 carriers.