| Abstrakt: |
The distribution of allele Ser447Ter of lipoprotein lipase gene (LPL) and polymorphic markers E2 and E4 of the apolipoprotein E gene (ApoE) were examined in 100 obese patients at the age of 18-66 years (28 men and 72 women, 40.6 +/- 2.1 years old). The first group included patients with I degree of obesity (n = 26, BMI = 32.5 +/- 0.2), the second group--patients with II degree of obesity (n = 33, BMI = 37.1 +/- 0.2), the third group--patients with grade III obesity (n = 41, BMI = 46.3-1.1) and control group were 18 healthy individuals aged from 22 to 55 years (7 men and 11 women, 36.5 +/- 0.9 years old, BMI = 22.4 +/- 1.8). Maximal frequency of allelic polymorphism epsilon2 has been revealed in patients with I degree of obesity, and allele epsilon4--in patients with III degree of obesity. The most common genotype of ApoE gene was epsilon3/epsilon3 in all three groups of patients with obesity. In a comparative analysis of allelic variants of the Apo E gene occurrence it has been found that the frequency of a polymorphic variant epsilon2/epsilon2 tended to decrease with BMI increasing, whereas a higher rate of detection of genotypes epsilon4/epsilon3, epsilon4/epsilon4 and epsilon2/epsilon4 was found in patients with III degree of obesity. The data obtained suggest that the epsilon4 allele of the Apo E gene is associated with the development of morbid obesity, rather than allele epsilon2. This phenomenon can be explained by the fact that apoE4 isoform has reduced affinity for LDL in comparison with apolipoprotein E3. The maximum concentration of cholesterol, triglycerides and LDL cholesterol has been observed in patients with epsilon2/epsilon4 genotype of ApoE gene, and it was significantly higher than in the control group (p < 0.05). The content of blood lipid fractions in patients with epsilon3/epsilon4 genotype of ApoE gene, in contrast, was the lowest among obese and did not exceed the values of the control group (p > 0.05). These data indicates a small contribution of epsilon4 polymorphism in heterozygous form to the development of dyslipidemia in obesity. The most positive effect of diet treatment was achieved in patients with genotype epsilon3/epsilon3 and epsilon3/epsilon4. An integrated approach to the assessment of lipid metabolism in patients with obesity, including the analysis of polymorphic genetic loci, can optimize and personalize the diet therapy. |
