Apolipoprotein ε4 polymorphism does not modify the association between body mass index and high-density lipoprotein cholesterol: A cross-sectional cohort study

Background: We sought to examine whether 4 carrier status modifies the relation between body mass index (BMI) and HDL. The National Heart, Lung, and Blood Institute Family Heart Study included 657 families with high family risk scores for coronary heart disease and 588 randomly selected families of probands in the Framingham, Atherosclerosis Risk in Communities, and Utah Family Health Tree studies. We selected 1402 subjects who had 4 carrier status available. We used generalized estimating equations to examine the interaction between BMI and 4 allele carrier status on HDL after adjusting for age, gender, smoking, alcohol intake, mono- and poly-unsaturated fat intake, exercise, comorbidities, LDL, and family cluster. Results: The mean (standard deviation) age of included subjects was 56.4(11.0) years and 47% were male. Adjusted means of HDL for normal, overweight, and obese BMI categories were 51.2( 0.97), 45.0( 0.75), and 41.6( 0.93), respectively, among 397 4 carriers (p for trend < 0.0001) and 53.6( 0.62), 51.3( 0.49), and 45.0( 0.62), respectively, among 1005 non-carriers of the 4 allele (p-value for trend < 0.0001). There was no evidence for an interaction between BMI and 4 status on HDL(p-value 0.39). Conclusion: Our findings do not support an interaction between 4 allele status and BMI on HDL.