Association Between ApoE Polymorphism in Obesity Markers in Healthy Adults Who Follow the Greek Orthodox Fasting Rules

• Main Authors: Alexandra A. Koulouri, Sousana K. Papadopoulou, Dimitrios Loukovitis, Nikolaos Rodopaios, Eleni Vasara, Maria Hassapidou, Fani Biskanaki, Dimitrios Tasoulas, Elias Tassoulas, Andrew J.S. Coats, Anthony Kafatos
• Format: Article
• Language: English
• Published: Barcaray International 2018-01-01
• Series: International Cardiovascular Forum Journal
• Subjects: diet; fasting; obesity
• Online Access: https://icfjournal.org/index.php/icfj/article/view/568/pdf

Aim Apolipoprotein E (ApoE) is one of the major triglyceride-rich lipoproteins, which acts as a genetic determinate of cardiovascular disease (CVD). A common polymorphism in this gene codes for 3 isoforms E2, E3 and E4 with equivalent allele ε2, ε3 and ε4, located on chromosome 19. Three alleles of apoE gene, e2, e3, and e4, are responsible for the major ApoE isoforms: ApoE2, ApoE3, and ApoE4. The ApoE phenotype has been reported to be the strongest genetic factor that affects serum lipid and lipoprotein concentrations, as well as influencing anthropometric parameters including obesity risk. Methods This case control study of randomly selected, free living individuals from North Greece investigated whether traditional Greek Orthodox dietary practices could affect obesity markers independent of genetic influences, by examining the association between ApoE genetic polymorphisms and BMI. Waist circumference (WC), waist hip ratio (WHR) and % fat mass (% FM), were measured in healthy adults who follow the rules of Greek Orthodox fasting compared to those who did not. 382 subjects (246 women and 136 men) were included in the analysis, 161 fasters and 220 non-fasters as a control group. Results Age affected obesity markers in all participants with more obesity in the older subjects. ApoE alleles did not differ between fasting and controls. When fasters where classified as obese and non-obese, there was no association with age (p>0,077). In the control group, BMI and WC were associated with age and gender and WHR with apoE alleles (p<0.001). In the fasting group these correlations are not observed (p=0.545 and p=0.365 respectively). In addition two-way ANOVA, including multiple comparison testing, demonstrated interactions between independent variables (sex, age apoE alleles and fasting status) and their influence on BMI, %BF and WHR. ApoE alleles and age significantly influence WHR (p=0.014). Between the three alleles statistically significant differences in WHR is observed only in the young participants; mean±SD is 0.82±0.08, 0.86±0.1 and 0.81±0.09 in E2, E3 and E4 carrier, respectively (p=0.04). Possibly Apo E4 showed a protective role against the increase of WHR, but age counterbalanced this effect. Conclusions Obesity and overweight rates were very high (66.9% men and 55.3% women). Age affected obesity markers in all participants. BF was higher, while WC and WHR were lower in women compared to men, independent of fasting status. However BMI values are smaller in women compared to men only in the controls. BMI did not differ significantly between the sexes in the fasting group; thus BMI is significantly higher in fasting women compared to non-fasting ones. In the present study we found that the effect of ApoE alleles on adiposity was associated with age. Between the three alleles statistically significant differences in WHR were observed only in the younger participants. Possibly Apo E4 played a protective role against the increase of WHR, but age counterbalanced this effect. In conclusion, even if genetic risks factor influence the susceptibility to obesity and cardiometabolic disorders, lifestyle changes may ameliorate these effects.