BACKGROUND: The genetically determined phenotypes of apolipoprotein E are related to variations in lipoprotein levels and in the enterohepatic metabolism of cholesterol and bile acids. The present study was designed to elucidate the role of apolipoprotein E polymorphism in gallstone formation. METHODS: Apolipoprotein E phenotype was determined in 169 consecutive cholecystectomy patients and in 200 controls. The cholesterol content of the gallstones (n = 169), the presence of cholesterol monohydrate crystals of fresh gallbladder bile (n = 142), and the nucleation time (n = 35) were also analyzed. RESULTS: The median cholesterol content of the gallstones was higher in the apolipoprotein E4 category (phenotypes E4/4 and E4/3, 97%) than in the E3 (E3/3, 78%) and E2 patients (E2/2 and E2/3, 76%, P = 0.0003). In E4 patients, cholesterol crystals were found immediately after surgery in 27 of 40 (68%), whereas in E3 and E2 groups in 36 of 88 (41%), and 4 of 14 (29%) of the patients (P = 0.0001). The median nucleation time in E4 patients (2.5 days) was shorter than in patients with E3 (5.5 days) or E2 (6.0 days) (P = 0.0016). CONCLUSIONS: These data indicate that apolipoprotein E polymorphism affects cholesterol content of cholelithiasis. We suggest that this phenomenon is mediated by the altered formation of cholesterol monohydrate crystals in different apolipoprotein E phenotypes.
BACKGROUND: The genetically determined phenotypes of apolipoprotein E are related to variations in lipoprotein levels and in the enterohepatic metabolism of cholesterol and bile acids. The present study was designed to elucidate the role of apolipoprotein E polymorphism in gallstone formation. METHODS:Apolipoprotein E phenotype was determined in 169 consecutive cholecystectomy patients and in 200 controls. The cholesterol content of the gallstones (n = 169), the presence of cholesterol monohydrate crystals of fresh gallbladder bile (n = 142), and the nucleation time (n = 35) were also analyzed. RESULTS: The median cholesterol content of the gallstones was higher in the apolipoprotein E4 category (phenotypes E4/4 and E4/3, 97%) than in the E3 (E3/3, 78%) and E2 patients (E2/2 and E2/3, 76%, P = 0.0003). In E4 patients, cholesterol crystals were found immediately after surgery in 27 of 40 (68%), whereas in E3 and E2 groups in 36 of 88 (41%), and 4 of 14 (29%) of the patients (P = 0.0001). The median nucleation time in E4 patients (2.5 days) was shorter than in patients with E3 (5.5 days) or E2 (6.0 days) (P = 0.0016). CONCLUSIONS: These data indicate that apolipoprotein E polymorphism affects cholesterol content of cholelithiasis. We suggest that this phenomenon is mediated by the altered formation of cholesterol monohydrate crystals in different apolipoprotein E phenotypes.
Authors: Sidney Pinheiro-Júnior; Marcela A S Pinhel; Marcelo A Nakazone; Anielli Pinheiro; Gisele F S Amorim; Greiciane M S Florim; Camila M Mazeti; Michele L Gregório; Marina G Moschetta; Gilberto B Brito; Sérgio L A Brienze; Carla B Nonino; Antonio C Brandão; Dorotéia R S Souza Journal: Obes Surg Date: 2012-04 Impact factor: 4.129
Authors: M Niemi; K Kervinen; A Rantala; H Kauma; M Päivänsalo; M J Savolainen; M Lilja; Y A Kesäniemi Journal: Gut Date: 1999-04 Impact factor: 23.059
Authors: Sobha Puppala; Gerald D Dodd; Sharon Fowler; Rector Arya; Jennifer Schneider; Vidya S Farook; Richard Granato; Thomas D Dyer; Laura Almasy; Christopher P Jenkinson; Andrew K Diehl; Michael P Stern; John Blangero; Ravindranath Duggirala Journal: Am J Hum Genet Date: 2006-01-06 Impact factor: 11.025
Authors: Floyd Willis; Neill Graff-Radford; Martin Pinto; LaShaune Lawson; Jennifer Adamson; Dawn Epstein; Francine Parfitt; Mike Hutton; Peter C O'Brien Journal: J Natl Med Assoc Date: 2003-01 Impact factor: 1.798