APOE Molecular Spectrum in a French Cohort with Primary Dyslipidemia.

Abstract

Primary hypercholesterolemia is characterized by elevated LDL-cholesterol (LDL-C) levels isolated in autosomal dominant hypercholesterolemia (ADH) or associated with elevated triglyceride levels in familial combined hyperlipidemia (FCHL). Rare APOE variants are known in ADH and FCHL. We explored the APOE molecular spectrum in a French ADH/FCHL cohort of 5743 unrelated probands. The sequencing of LDLR, PCSK9, APOB, and APOE revealed 76 carriers of a rare APOE variant, with no mutation in LDLR, PCSK9, or APOB. Among the 31 APOE variants identified here, 15 are described in ADH, 10 in FCHL, and 6 in both probands. Five were previously reported with dyslipidemia and 26 are novel, including 12 missense, 5 synonymous, 2 intronic, and 7 variants in regulatory regions. Sixteen variants were predicted as pathogenic or likely pathogenic, and their carriers had significantly lower polygenic risk scores (wPRS) than carriers of predicted benign variants. We observed no correlation between LDL-C levels and wPRS, suggesting a major effect of APOE variants. Carriers of p.Leu167del were associated with a severe phenotype. The analysis of 11 probands suggests that carriers of an APOE variant respond better to statins than carriers of a LDLR mutation. Altogether, we show that the APOE variants account for a significant contribution to ADH and FCHL.

• Authors: Yara Abou Khalil, Oriane Marmontel, Jean Ferrières, François Paillard, Cécile Yelnik, Valérie Carreau, Sybil Charrière, Eric Bruckert, Antonio Gallo, Philippe Giral, Anne Philippi, Olivier Bluteau, Catherine Boileau, Marianne Abifadel, Mathilde Di-Filippo, Alain Carrié, Jean-Pierre Rabès, Mathilde Varret
• Journal: International journal of molecular sciences (Int J Mol Sci) Vol. 23 Issue 10 (May 21 2022) ISSN: 1422-0067 [Electronic] Switzerland
• PMID: 35628605 (Publication Type: Journal Article)

Chemical References

• ApoE protein, human
• Apolipoproteins E
• Cholesterol, LDL
• Proprotein Convertase 9

Topics

• Apolipoproteins E (genetics, metabolism)
• Cholesterol, LDL (genetics, metabolism)
• Humans
• Hyperlipoproteinemia Type II (genetics, metabolism)
• Proprotein Convertase 9 (genetics, metabolism)