Background/Aim. Atherosclerosis is still the leading cause of death in
Western world. Development of atherosclerotic plaque involves accumulation of
inflammatory cells, lipids, smooth muscle cells and extracellular matrix
proteins in the intima of the vascular wall. Apolipoprotein E participates in
the transport of exogenous cholesterol, endogenouly synthesized lipids and
triglycerides in the organism. Apolipoprotein E gene has been identified as
one of the candidate genes for atherosclerosis. Previous studies in different
populations have clearly implicated apolipoprotein E genetic variation (?
polymorphisms) as a major modulator of low density lipoprotein cholesterol
levels. Data considering apolipoprotein E polymorphisms in relation to
carotid atherosclerosis gave results that are not in full compliance. The aim
of present study was to investigate the apolipoprotein E polymorphisms in
association with carotid plaque presence, apolipoprotein E and lipid serum
levels in patients with carotid atherosclerosis from Serbia. Methods. The
study group enrolled 495 participants: 285 controls and 210 consecutive
patients with carotid atherosclerosis who underwent carotid endarterectomy.
Genotyping of apolipoprotein E polymorphisms were done using polymerase chain
reaction and restriction fragment length polymorphism methods. Results.
Patients had significantly decreased frequency of the ?2 allele compared to
controls. Patients who carry at least one ?2 allele had a significantly
higher level of serum apolipoprotein E and significantly lower low density
lipoprotein cholesterol levels compared to those who do not carry this
allele. Conclusion. Our results suggest protective effect of apolipoprotein E
?2 allele on susceptibility for carotid plaque presence as well as low
density lipoprotein cholesterol lowering effect in Serbian patients with
carotid atherosclerosis. Further research of multiple gene and environmental
factors that contribute to the appearance and the progression of
atherosclerosis should be continued with respect to different populations.