Apolipoprotein E (ApoE) is an important regulator of cholesterol and triglyceride levels in your blood, and supports lipid transport and injury repair in your brain.
The ApoE gene codes for proteins that are involved in the metabolism of cholesterol, but in particular they play a really important role in the development of cardiovascular disease and Alzheimer’s disease. Knowing your APOE status allows you to determine what you need to do to mitigate those risks, both through nutrition, and medication.
There are three different forms of the ApoE gene known as E2, E3 and E4 alleles. Genetically, E4 is the strongest risk factor for developing LOAD, an acronym for “late-onset Alzheimer’s disease” (typically >65 years).
In the cardiovascular system ApoE is involved in the transportation of fat molecules out of circulation and into your cells. Each of the allele variations, E2, E3 and E4 mediate cholesterol metabolism in a different manner. E4 is associated with increased levels of cholesterol and triglycerides, which leads to atherosclerosis, heart disease and stroke. According to the National Institute of Health, inheriting a single copy of ApoE4 from a parent increases the risk of Alzheimer’s disease by about three-fold. Inheriting two copies, one from each parent, increases the risk by about 12-fold. Almost 40% of Alzheimer’s Disease patients have inherited an E4 allele.
See table below
|Allele Type||Cardiac Risk||Alzheimer’s Risk|
|E2||Associated with a decreased risk for cardiovascular disease except for individuals with hyperlipoproteinemia.||Studies indicate that people with this variant are at a reduced risk for developing Late Onset Alzheimer’s Disease.|
|E3||Considered the non-risk group for cardiovascular disease.||Results in normal expression of APOE and believed to play a neutral role in the disease, neither increasing or decreasing risk.|
|E4||Associated with the highest risk for cardiovascular disease due to decreased HDL levels, increased triglycerides1 and cholesterol levels (both total and LDL). It is also associated with increased risk of heart attack and stroke.||E4/E4 carries the highest risk and may increase risk up to 12 fold with an earlier age of disease onset.8 The APOE4 variant is implicated in 40% of Alzheimer’s cases.|