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The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention

  • Lanny C. Gultom EMAIL logo , Damayanti R. Sjarif , Herawati A. Sudoyo , Muchtaruddin Mansyur , Sri Rezeki S. Hadinegoro , Suzanna Immanuel and Mexitalia Setiawati
Published/Copyright: April 14, 2015
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 28 Issue 5-6

Abstract

Background: Lifestyle changes are important factors for managing dyslipidemia before considering blood lipid-lowering drugs. However, genetic factors can influence the response outcome.

Objective: We aimed to determine a dyslipidemia management strategy in obese adolescents.

Patients and methods: A total of 60 dyslipidemic obese adolescents received physical exercise and the NCEP step II diet for 28 days. Apolipoprotein E (apo E) genotypes and blood lipid levels were compared before and after interventions.

Results: The apo E3/E3 genotype was found to be common in all subjects. Mean levels of total cholesterol, triglyceride, and low-density lipoprotein-cholesterol (LDL-C) improved in subjects with the E3 allele after the intervention, but not the E2 allele. Total cholesterol and LDL-C, but not triglyceride levels, improved in subjects with the E4 allele.

Discussion: Apo E alleles might influence improvement in lipid profiles after diet and exercise interventions. These results could inform personalized dyslipidemia management in obese adolescents, to determine which subjects would benefit from blood lipid-lowering drugs.

Keywords: Apo E; dyslipidemia; NCEP step II diet; physical exercise
Corresponding author: Lanny C. Gultom, Child Health Department of Fatmawati Hospital, Jl. RS Fatmawati, Cilandak, Jakarta Selatan, 12430, Indonesia, Phone: +62217501524, Fax: +622175911454, E-mail:

References

1. US Preventive Services Task Force. Screening for lipid disorders in children: US Preventive Services Task Force Recommendation Statement. Pediatrics 2007;120:e215–9.10.1542/peds.2006-1812Search in Google Scholar PubMed

2. Garg A, Simha V. Update on dyslipidemia. J Clin Endocrinol Metab 2007;92:1581–9.10.1210/jc.2007-0275Search in Google Scholar PubMed

3. Stamford BA, Moffatt RJ. Lipids and health: past, present, and future. In: Moffatt RJ, Stamford B, editors. Lipid metabolism and health. Boca Raton: Taylor and Francis Group, 2006:1–11.Search in Google Scholar

4. Franklin BA, Durstine JL, Roberts CK, Barnard RJ. Impact of diet and exercise on lipid management in the modern era. Best Pract Res Cl En 2014:28:405–21.10.1016/j.beem.2014.01.005Search in Google Scholar PubMed

5. McGill HC Jr, McMahan CA, Gidding SS. Preventing heart disease in the 21st century: implications of the pathobiological determinants of the atherosclerosis in youth (PDAY) study. Circulation 2008;117:1216–27.10.1161/CIRCULATIONAHA.107.717033Search in Google Scholar PubMed

6. Hariyanto D, Madiyono B, Sjarif DR, Sastroasmoro S. Hubungan ketebalan tunika intima media arteri carotis dengan obesitas pada remaja. Sari Pediatri 2009;11:159–66.10.14238/sp11.3.2009.159-66Search in Google Scholar

7. Cesar L, Suarez SV, Adi J, Adi N, Vazquez-Padron R, et al. An essential role for diet in exercise-mediated protection against dyslipidemia, inflammation and atherosclerosis in ApoE-/- mice. PLoS One 2011;6:e17263.10.1371/journal.pone.0017263Search in Google Scholar PubMed PubMed Central

8. Walden CC, Hegele RA. Apolipoprotein E in hyperlipidemia. Ann Intern Med 1994;120:1026–36.10.7326/0003-4819-120-12-199406150-00009Search in Google Scholar PubMed

9. Ye SQ, Kwiterovich PO. Influence of genetic polymorphisms on responsiveness to dietary fat and cholesterol. Am J Clin Nutr 2000;72(Suppl):1275S–84S.10.1093/ajcn/72.5.1275sSearch in Google Scholar PubMed

10. Elliott R, Ong TJ. Nutritional genomics. Brit Med J 2002;324:1438–42.10.1136/bmj.324.7351.1438Search in Google Scholar PubMed PubMed Central

11. Haan MN, Mayeda ER. Apolipoprotein E genotype and cardiovascular diseases in the elderly. Curr Cardio Risk Rep 2010;4:361–8.10.1007/s12170-010-0118-4Search in Google Scholar PubMed PubMed Central

12. Shin MH, Choi JS, Rhee JA, Lee YH, Nam HS, et al. APOE polymorphism and carotid atherosclerosis in Korean population: the Dong-gu Study and the Namwon Study. Atherosclerosis 2014;232:180–5.10.1016/j.atherosclerosis.2013.11.027Search in Google Scholar

13. Ariza MJ, Sanchez-Chaparro MA, Barón FJ, Hornos AM, Calvo-Bonacho E, et al. Additive effects of LPL, APOA5 and APOE variant combinations on trygliceride levels and hypertriglyceride level and hypertriglyceridemia: results of the ICARIA genetic sub-study. BMC Med Genet 2010;11:66.10.1186/1471-2350-11-66Search in Google Scholar

14. Povel CM, Boer JM, Imholz S, Dollé ME, Feskens EJ. Genetic variants in lipid metabolism are independently associated with multiple features of the metabolic syndrome. Lipids Health Dis 2011;10:118.10.1186/1476-511X-10-118Search in Google Scholar

15. Boulenouar H, Benchekor SM, Meroufel DN, Hetraf SA, Djellouli HO, et al. Impact of APOE gene polymorphisms on the lipid profile in an Algerian population. Lipids Health Dis 2013;12:155.10.1186/1476-511X-12-155Search in Google Scholar

16. Biswas S, Ghoshal PK, Halder B, Ganguly K, DasBiswas A, et al. Apolipoproteins AI/B/E gene polymorphism and their plasma levels in patients with coronary artery disease in a tertiary care-center of Eastern India. Indian Heart J 2013;65:658–65.10.1016/j.ihj.2013.10.003Search in Google Scholar

17. Chaudhary R, Likidlilid A, Peerapatdit T, Tresukosol D, Srisuma S, et al. Apolipoprotein E gene polymorphism: effects on plasma lipids and risk of type 2 diabetes and coronary artery disease. Cardiovasc Diabetol. 2012;11:36.10.1186/1475-2840-11-36Search in Google Scholar

18. Hagberg JM, Wilund KR, Ferrell RE. APO E gene and gene-environment effects on plasma lipoprotein-lipid levels. Physiol Genomics 2000;4:101–8.10.1152/physiolgenomics.2000.4.2.101Search in Google Scholar

19. Taimela S, Lehtimaki T, Porkka K, Rasanen L, Viikari J. The effect of physical activity on serum total and low-density lipoprotein cholesterol concentration varies with apolipoprotein E phenotype in male children and young adults: the cardiovascular risk in young Finns study. Metabolism 1996;45:797–803.10.1016/S0026-0495(96)90149-3Search in Google Scholar

20. St-Amand J, Prud’homme D, Moorjani S, Nadeau A, Tremblay A, et al. Apolipoprotein E polymorphism and the relationships of physical fitness to plasma lipoprotein-lipid levels in men and women. Med Sci Sports Exerc 1999;31:692–7.10.1097/00005768-199905000-00011Search in Google Scholar PubMed

21. Ferreira AP, Ferreira CB, Brito CJ, Souza VC, Córdova C, et al. The effect of aerobic exercise intensity on attenuation of postprandial lipemia is dependent on apolipoprotein E genotype. Atherosclerosis 2013;229:139–44.10.1016/j.atherosclerosis.2013.03.027Search in Google Scholar PubMed

22. Paula RS, Souza VC, Benedet AL, Souza ER, Toledo JO, et al. Dietary fat and apolipoprotein genotypes modulate plasma lipoprotein levels in Brazilian elderly women. Mol Cell Biochem 2010;337:307–15.10.1007/s11010-009-0313-0Search in Google Scholar

23. Barlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120:S164–92.10.1542/peds.2007-2329CSearch in Google Scholar

24. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Expert Panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011;128(Suppl):213S–56S.10.1542/peds.2009-2107CSearch in Google Scholar

25. Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, et al. Effects of the National Cholesterol Education Program’s step I and step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr 1999;69:632–46.10.1093/ajcn/69.4.632Search in Google Scholar

26. Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, et al. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Eng J Med 1998;339:12–20.10.1056/NEJM199807023390103Search in Google Scholar

27. Varady KA, Jones PJ. Combination diet and exercise interventions for the treatment of dyslipidemia: an effective preliminary strategy to lower cholesterol levels? J Nutr 2005;135:1829–35.10.1093/jn/135.8.1829Search in Google Scholar

28. Miller ER, Erlinger TP, Young DR, Jehn M, Charleston J, et al. Results of the diet, exercise, and weight loss intervention trial (DEW-IT). Hypertension 2002;40:612–8.10.1161/01.HYP.0000037217.96002.8ESearch in Google Scholar

29. Andersen RE, Wadden TA, Bartlett SJ, Zemel B, Verde TJ, et al. Effects of lifestyle activity vs structured aerobic exercise in obese women. J Am Med Assoc 1999;281:335–40.10.1001/jama.281.4.335Search in Google Scholar

30. Wilund KR, Ferrell RE, Phares DA, Goldberg AP, Hadberg JM. Changes in high-density lipoprotein-cholesterol subfractions with exercise training may be dependent on cholesteryl ester transfer protein (CETP) genotype. Metabolism 2002;51:774–8 (Abstract).10.1053/meta.2002.32730Search in Google Scholar

31. Williams PT, Krauss RM, Stefanick ML, Vranizan KM, Wood PD. Effects of low-fat diet, calorie restriction, and running on lipoprotein subfraction concentracions in moderately overweight men. Metabolism 1994;43:655–63.10.1016/0026-0495(94)90210-0Search in Google Scholar

32. Niebauer J, Hambrecht R, Velich T, Hauer K, Marburger C, et al. Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise. Circulation 1997;96:2534–41.10.1161/01.CIR.96.8.2534Search in Google Scholar PubMed

33. NCEP expert panel on blood cholesterol levels in children and adolescents. National Cholesterol Education Program (NCEP): highlights of the report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 1992;89:495–501.10.1542/peds.89.3.495Search in Google Scholar

34. Holmes KW, Kwiterovich PO. Treatment of dyslipidemia in children and adolescents. Curr Cardiol Rep 2005;7:445–56.10.1007/s11886-005-0063-xSearch in Google Scholar PubMed

35. Leon AS, Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001;33:502–15.10.1097/00005768-200106001-00021Search in Google Scholar PubMed

36. Angelopoulos TJ. Obesity, lipoproteins, and exercise. In: Moffatt RJ, Stamford B, editors. Lipid metabolism and health. Boca Raton: Taylor and Francis Group, 2006:173–82.Search in Google Scholar

Received: 2014-2-14
Accepted: 2014-12-8
Published Online: 2015-4-14
Published in Print: 2015-5-1

©2015 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Obesity
  3. Childhood obesity at the crossroads
  4. Obesogenic environments: environmental approaches to obesity prevention
  5. Childhood obesity and eating behaviour
  6. Hypothalamic obesity in children: pathophysiology to clinical management
  7. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children
  8. Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
  9. The effect of body mass index on blood pressure varies by race among obese children
  10. Insulin secretion response during oral glucose tolerance test is related to low cardiorespiratory fitness in obese adolescents
  11. Is there a relationship between cardiovascular risk factors and dehydroepiandrosterone sulfate levels in childhood obesity?
  12. The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children
  13. Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
  14. Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children
  15. Osteocalcin is inversely associated with adiposity and leptin in adolescent boys
  16. Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children
  17. Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach
  18. The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention
  19. Review article
  20. Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?
  21. Original articles
  22. IGF-II expression and methylation in small for gestational age infants
  23. Early screening of FTO and MC4R variants in newborns of Greek origin
  24. Pitfalls in hormonal diagnosis of 17-beta hydroxysteroid dehydrogenase III deficiency
  25. The prevalence of vitamin D deficiency among schoolchildren: a cohort study from Xinxiang, China
  26. Management of testosterone therapy in adolescents and young men with hypogonadism: are we following adult clinical practice guidelines?
  27. Vitamin D status and its associations with components of metabolic syndrome in healthy children
  28. Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
  29. Patient reports
  30. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene
  31. Ovarian carcinoma in a 14-year-old with classical salt-wasting congenital adrenal hyperplasia and bilateral adrenalectomy
  32. An asymptomatic mother diagnosed with 3-methylcrotonyl-CoA carboxylase deficiency after newborn screening
  33. A new missense mutation in the BCKDHB gene causes the classic form of maple syrup urine disease (MSUD)
  34. Ovotesticular disorder of sex development with unusual karyotype: patient report
  35. First case report of medium-chain acyl-coenzyme A dehydrogenase deficiency in China
  36. Virilizing adrenal oncocytoma in a 9-year-old girl: rare neoplasm with an intriguing postoperative course
  37. Unexpected clinical features in a female patient with proopiomelanocortin (POMC) deficiency
  38. Sirolimus therapy in a patient with severe hyperinsulinaemic hypoglycaemia due to a compound heterozygous ABCC8 gene mutation
  39. Cross-reactivity of adrenal steroids with aldosterone may prevent the accurate diagnosis of congenital adrenal hyperplasia
  40. Hyperthyroidism hidden by congenital central hypoventilation syndrome
  41. The use of pamidronate for acute vitamin D intoxication, clinical experience with three cases
  42. Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
  43. Cushing syndrome related to leukemic infiltration of the central nervous system
  44. Hashimoto’s encephalopathy: a rare pediatric brain disease
  45. Short communication
  46. A novel ABCD1 gene mutation in a Chinese patient with X-linked adrenoleukodystrophy
https://doi.org/10.1515/jpem-2014-0070
Keywords for this article
Apo E; dyslipidemia; NCEP step II diet; physical exercise

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Obesity
  3. Childhood obesity at the crossroads
  4. Obesogenic environments: environmental approaches to obesity prevention
  5. Childhood obesity and eating behaviour
  6. Hypothalamic obesity in children: pathophysiology to clinical management
  7. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children
  8. Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
  9. The effect of body mass index on blood pressure varies by race among obese children
  10. Insulin secretion response during oral glucose tolerance test is related to low cardiorespiratory fitness in obese adolescents
  11. Is there a relationship between cardiovascular risk factors and dehydroepiandrosterone sulfate levels in childhood obesity?
  12. The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children
  13. Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
  14. Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children
  15. Osteocalcin is inversely associated with adiposity and leptin in adolescent boys
  16. Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children
  17. Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach
  18. The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention
  19. Review article
  20. Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?
  21. Original articles
  22. IGF-II expression and methylation in small for gestational age infants
  23. Early screening of FTO and MC4R variants in newborns of Greek origin
  24. Pitfalls in hormonal diagnosis of 17-beta hydroxysteroid dehydrogenase III deficiency
  25. The prevalence of vitamin D deficiency among schoolchildren: a cohort study from Xinxiang, China
  26. Management of testosterone therapy in adolescents and young men with hypogonadism: are we following adult clinical practice guidelines?
  27. Vitamin D status and its associations with components of metabolic syndrome in healthy children
  28. Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
  29. Patient reports
  30. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene
  31. Ovarian carcinoma in a 14-year-old with classical salt-wasting congenital adrenal hyperplasia and bilateral adrenalectomy
  32. An asymptomatic mother diagnosed with 3-methylcrotonyl-CoA carboxylase deficiency after newborn screening
  33. A new missense mutation in the BCKDHB gene causes the classic form of maple syrup urine disease (MSUD)
  34. Ovotesticular disorder of sex development with unusual karyotype: patient report
  35. First case report of medium-chain acyl-coenzyme A dehydrogenase deficiency in China
  36. Virilizing adrenal oncocytoma in a 9-year-old girl: rare neoplasm with an intriguing postoperative course
  37. Unexpected clinical features in a female patient with proopiomelanocortin (POMC) deficiency
  38. Sirolimus therapy in a patient with severe hyperinsulinaemic hypoglycaemia due to a compound heterozygous ABCC8 gene mutation
  39. Cross-reactivity of adrenal steroids with aldosterone may prevent the accurate diagnosis of congenital adrenal hyperplasia
  40. Hyperthyroidism hidden by congenital central hypoventilation syndrome
  41. The use of pamidronate for acute vitamin D intoxication, clinical experience with three cases
  42. Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
  43. Cushing syndrome related to leukemic infiltration of the central nervous system
  44. Hashimoto’s encephalopathy: a rare pediatric brain disease
  45. Short communication
  46. A novel ABCD1 gene mutation in a Chinese patient with X-linked adrenoleukodystrophy
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