Influence of Apolipoprotein E Polymorphism on Bezafibrate Treatment Response in Dyslipidemic Patient

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  • Yamada Masamichi
    Department of Internal Medicine, St. Marianna University School of Medicine Tohyoko Hospital

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To examine the significance of apolipoprotein E (apo E) polymorphism in the hypolipidemic effect of bezafibrate, we evaluated the influence of different apo E phenotypes on serum lipid response to bezafibrate treatment in 58 dyslipidemic patients with WHO phenotypes of llb, IV, or isolated hypo-HDL cholesterolemia. Patients were categorized into one of three groups according to apo E phenotypes of E2 (E2/3, n = 5), E3 (E3/3, n = 35), and E4 (E3/ 4 and E4/4, n=18). After 3 months daily administration of 400 mg bezafibrate, serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) levels changed on average in the E3 group [-8.0% ; p< 0.05 and +1.1% ; not significant (ns), respectively], the E2 group (-18.3% ; p<0.005 and-26.9%; p<0.05, respectively) and the E4 group (+3.8%; ns and +10.1%; ns, respectively). The changes in TC and LDLC levels in the E4 group was significantly less effective compared with those in the E3 (p < 0.05) and E2 groups (p < 0.01). Bezafibrate induced a reduction in serum triglyceride (TG) levels in the E3 group (-50.1%; p < 0.0001), the E2 group (-46.9% ; p < 0.05) and the E4 group (-44.8% ; p < 0.005). An increase in high-density lipoprotein cholesterol (HDLC) levels was also observed in the E3 group (+ 27.5% ; p< 0.0001), the E2 group (+ 35.0% ; ns) and the E4 group (+ 38.8% ; p< 0.005). However, there was no significant difference in the changes of TG and HDLC levels between the groups. These results suggest an important role of apo E polymorphism in modulating serum lipid response to bezafibrate, and phenotyping of apo E helps predict the therapeutic effect of bezafibrate treatment. J Atheroscler Thromb, 1997 ; 4 : 40-44.

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