Statin response may be caused by genetics

Statin response may be genetically determined, a research team from Tayside has reported.

Genetic subgroups may need to be started on aggressive high-dose statin therapy to reach recommended lipid reduction targets, suggested Dr Colin Palmer, senior lecturer in the Biomedical Research Centre at Ninewells Hospital in Dundee, at the conference.

Carriers of gene variants known to affect lipid metabolism might fail to achieve recommended levels on standard therapy, Dr Palmer told the Primary Care Genetics Society conference.

Three-quarters of diabetes patients the apolipoprotein E4 (apoE4) allele never reached an LDL-cholesterol of <2mmol/l, the Tayside Go-DARTS study showed.

The apoE4 carriers' LDL-cholesterol dropped less significantly and post-treatment levels remained higher than in diabetics not carrying the apoE4 variant.

But Dr Palmer found that over 57 per cent of diabetics without the apoE4 allele did reach the recommended level.

'The apoE4 gene variant effect was most pronounced in individuals who were only mildly dyslipidaemic,' Dr Palmer said.

His team looked at 28 post-treatment lipid measurements from 953 diabetics who took statins over the 10-year period to May 2003.

ApoE4 defects result in increased plasma cholesterol due to impaired clearance of chylomicron and VLDL remnants.

The Tayside apoE4 carriers failed to reach recommended levels regardless of their baseline LDL, the researchers found.

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