The Role Of APOE Genotype In The Relationship Between Osteoporosis And Atherosclerotic Cardiovascular Disease

Objective:We aimed to explore the role of APOE genotype in the relationship between osteoporosis(OP)and atherosclerotic cardiovascular disease(ASCVD),so as to raise people's awareness,provide certain clinical basis for the prevention of bone metabolism and lipid metabolism diseases,reduce the disability rate and death rate of osteoporosis and atherosclerotic cardiovascular diseases,and improve people's quality of life.Methods:A total of 150 patients were collected,who met the eligibility criteria during their stay in Affiliated people's hospital of shanxi medical university from November 2018 to August2019.They were divided into 40 patients with osteoporosis or bone loss but no ASCVD(group A),36 patients with ASCVD alone(group B),36 patients with both osteoporosis and ASCVD(group C),38 patients with neither osteoporosis nor ASCVD(group D).The four groups were matched with each other in terms of sex ratio,mean age and body mass index(BMI),and the bone metabolism indexes,biochemistry and blood lipids of each group were determined.The APOE genotype was determined using the polymerase chain reaction(PCR)method,bone mineral density(BMD)was determined by dual energy X-ray absorptiometry(DXA),and ASCVD was diagnosed by carotid ultrasound.Results:1.Distribution of APOE genotypes in different groups and genders: the distribution of APOE gene polymorphism was independent of gender,and the difference was not statistically significant.The proportions of APOE4 genotype with osteoporosis and ASCVD were 36.4%.2.The prevalence rate of ASCVD diseases was different between different APOE genotypes: patients with APOE4 genotype had the highest percentage of ASCVD diseases(up to 68.2%).3.The distribution of APOE genotypes in the four groups: the highest distribution frequency was the e3/3 genotype(up to 54.7%).4.The relationship between bone metabolic index,biochemical index and APOE genotypes: compared with APOE2 and APOE4 genotype,patients with APOE3 genotype had higher levels of alkaline phosphatase(AKP)and osteocalcin(OC),with statistically significant differences.The ?-type I collagen carboxy-terminal peptide(?-CTX)of APOE2 and APOE4 genotypes was higher than that of APOE3 genotype,and the difference was statistically significant.5.Lipid levels of patients with different APOE genotypes: the levels of total cholesterol(CHO),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in patients with APOE4 genotype were higher than those of APOE2 and APOE3 genotypes,and the levels of high density lipoprotein cholesterol(HDL-C)were lower than those of APOE2 and APOE3 genotypes,the difference was statistically significant.6.Bone mineral density level of patients with different APOE genotypes: the bone mineral density of L1-L4 and femoral neck of patients with APOE4 genotype was significantly lower than that of patients with APOE2 and APOE3 genotypes,and the difference was statistically significant.Conclusion:1.APOE4 genotype is associated with low bone density in L1-L4 and Neck,APOE2 and APOE4 genotype were associated with higher concentrations of serum ?-CTX,APOE3 genotype was associated with higher serum levels of AKP and OC,so APOE4 was a risk factor for osteoporosis.2.APOE4 genotype is associated with the incidence of atherosclerotic cardiovascular disease.3.Therefore,APOE4 genotype may be a common risk factor for osteoporosis and atherosclerotic cardiovascular disease.Due to the small sample size,it is impossible to draw a definite conclusion,but people with the APOE4 genotype have a higher risk of developing the diseases,it can be used as a certain guiding basis in clinic.