Study on correlation of ApoE and SLCO1B1 gene polymorphisms with lipid-lowering efficacy of statins
Objective To analyze the correlation of apolipoprotein E (ApoE) and solute carrier organic anion transporterfamily member 1 B1 (SLCO1B1) gene polymorphisms with lipid-lowering efficacy of statins,so as to provide reference for the precision use of statins. Methods A total of 300 patients with cardiovascular and cerebrovascular diseases who were initially diagnosed and required lipid-lowering treatment with statins were selected. At the time of enrollment,all patients were tested for blood lipid indicators and ApoE and SLCO1B1 gene polymorphisms. They were divided into a conventional group and an individualized group using a random number table method,with 150 cases in each group. The conventional group received standard-dose statin treatment,while the individualized group received personalized statin treatment (adjusting the type and dosage of medication based on ApoE and SLCO1B1 genotypes). Comparison was made on distribution of ApoE and SLCO1B1 genotypes,blood lipid indicators[triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C)],liver function indicators[aspartate transaminase (AST),alanine aminotrasferase (ALT)]and creatine kinase (CK) levels before and after treatment,rate of reaching lipid targets and time to reach lipid targets after treatment,and occurrence of adverse reactions between the two groups. Results Among the 300 patients,there were 63 cases (21.00％) with protective ApoE genotypes,173 cases (57.67％) with common genotypes,and 64 cases (21.33％) with risk genotypes. For SLCO1B1 genotypes,there were 190 cases (63.33％) with low-risk genotypes,83 cases (27.33％) with medium-risk genotypes,and 27 cases (9.00％) with high-risk genotypes. The differences in the distribution of ApoE genotypes and SLCO1B1 genotypes between the two groups of patients were not statistically significant (P>0.05). After treatment,the levels of TG,TC,and LDL-C in both groups were lower than those before treatment in this group,and the HDL-C level was higher than that before treatment in this group. The difference was statistically significant (P<0.05). The levels of TG,TC,and LDL-C were (1.86±0.18),(5.30±0.43),and (3.45±0.36) mmol/L in the individualized group,which were lower than (2.38±0.29),(5.52±0.49),and (3.61±0.38) mmol/L in the conventional group,and the difference was statistically significant (P<0.05). There was no statistically significant difference in HDL-C level between the two groups (P>0.05). After treatment,the rate of reaching lipid targets was 97.33％ in the individualized group,which was higher than 70.67％ in the conventional group,and the difference was statistically significant (P<0.05). The time to reach lipid targets was (22.40±2.81) d in the individualization group,which was shorter than (26.72±3.86) d in the conventional group,and the difference was statistically significant (P<0.05). The incidence rate of adverse reactions was 3.33％ in the individualized group and 4.00％ in the conventional group,and the difference was not statistically significant in comparison (P>0.05). There was no statistically significant difference in the comparison of AST,ALT and CK levels between and within the two groups before and after treatment (P>0.05). Conclusion The distribution of ApoE and SLCO1B1 genotypes in Guangxi region is basically consistent with the domestic distribution. Guided by ApoE and SLCO1B1 gene polymorphisms. The lipid-lowering treatment of statins guided by ApoE and SLCO1B1 gene polymorphisms can improve the lipid-lowering effect,and ApoE and SLCO1B1 gene polymorphisms can be used as auxiliary indexes to predict the lipid-lowering effect of statins in patients with cardiovascular diseases.
万方数据
维普
