Apolipoprotein (
apo) B is the structural
protein moiety of plasma
low density lipoprotein (
LDL), an important risk factor for
coronary heart disease (CHD). There is evidence that the rate of synthesis of
apoB-containing
lipoproteins may play an important role in the regulation of plasma
LDL levels. However, it is generally thought that transcriptional regulation of the
apoB gene is not a significant determinant of the synthesis of
apoB-containing
lipoproteins, and by inference, of the regulation of the plasma
LDL concentration. Here we report the discovery of a common polymorphism in the promoter region of the
apoB gene, a C to T substitution at position -516. The -516T allele is associated with an increase in the basal transcription of the
apoB gene (+41%, P < 0.05) in vitro in transfected HepG2 cells. Healthy middle-aged men who are homozygous for the -516T allele have 12% higher plasma
LDL cholesterol levels than healthy homozygotes for the -516C allele (P < 0.05). The frequency of the -516T allele is significantly higher in young postinfarction patients (0.38) than in population-based controls (0.30) when the comparison is restricted to subjects without severe
hypercholesterolemia who are homozygous for the
apoE3 allele (P < 0.05). It is concluded that variation in the rate of transcription of the
apoB gene can affect plasma
LDL levels and influences the risk of CHD in middle-aged men.