Abstract:

Objective: To explore the correlation between apolipoprotein E (ApoE) gene polymorphism and blood lipid levels with pulmonary tuberculosis. Methods: A retrospective study was conducted in 1118 patients diagnosed with pulmonary tuberculosis in Meizhou People’s Hospital from January 1, 2016 to December 12, 2020 (case group), and 582 healthy people in the hospital during the same period were selected as the control group. The general information (age, sex) and laboratory test indicators (blood routine test, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (Apo-A1), apolipoprotein B (Apo-B), and ApoE genotyping test results) of the subjects were collected. The distribution of ApoE genotypes, differences in blood lipid levels, and the correlation between ApoE genotypes and blood lipid levels between the case group and the control group were analyzed, and multivariate logistic regression was used to analyze the impact of ApoE genotypes and blood lipid levels on the incidence of pulmonary tuberculosis. Results: The levels of TG, TC, HDL-C, LDL-C, Apo-A1, and Apo-B in the case group were 1.23 (0.76, 1.47) mmol/L, (4.18±1.17) mmol/L, (1.14±0.38) mmol/L, (2.36±0.82) mmol/L, (0.94±0.32) g/L, and (0.79±0.26) g/L, respectively, and were all lower than those in the control group (1.64 (1.07, 2.06) mmol/L, (5.24±1.18) mmol/L, (1.36±0.34) mmol/L, (2.98±0.90) mmol/L, (1.31±0.33) g/L, (0.97±0.29) g/L, respectively), and the differences were statistically significant (U=-12.603, t=17.605, t=12.096, t=13.784, t=22.614, t=12.071, all P values <0.001). The TG, TC, HDL-C, LDL-C, Apo-A1, and Apo-B levels of individuals carrying the ApoE ε2/ε3 genotype in the case group were 1.21 (0.73, 1.38) mmol/L, (3.81±1.21) mmol/L, (1.17±0.36) mmol/L, (2.01±0.79) mmol/L, (0.96±0.32) g/L, and (0.67±0.22) g/L, respectively, lower than those in the control group (1.56 (0.96, 1.95) mmol/L, (4.78±1.03) mmol/L, (1.42±0.39) mmol/L, (2.50±0.81) mmol/L, (1.39±0.36) g/L, (0.83±0.28) g/L, respectively), and the differences were statistically significant (U=-3.805, t=5.009, t=3.968, t=3.666, t=7.755, t=3.491, all P values <0.001). The levels of TC, LDL-C, and Apo-B in patients carrying the ApoE ε2/ε3 genotype in the case group were (3.81±1.21) mmol/L, (2.01±0.79) mmol/L, and (0.67±0.22) g/L, respectively, which were lower than those carrying the ApoE ε3/ε3 genotype ((4.21±1.09) mmol/L, (2.40±0.76) mmol/L, and (0.81±0.25) g/L, respectively), with statistically significant differences (t values were 0.471, 5.595, and 5.681, respectively, all P values <0.001). The genotype frequency of ApoE ε2/ε3 genotype in the case group was 13.1% (146/1118),which was significantly higher than that in the control group (8.4% (49/582); χ ²=8.114, P=0.004). ε2 allele frequency in the case group (7.7% (174/2236)) was significantly higher than that of the control group (5.8% (67/1164); χ ²=4.770, P=0.029). Multivariate logistic regression analysis showed that carrying the ApoE ε2/ε3 genotypes (OR (95%CI)=1.763 (1.167-2.661))and ε2 allele gene (OR (95%CI)=1.630 (1.097-2.421)) were risk factors for pulmonary tuberculosis. Conclusion: Carrying ApoE ε2/ε3 genotype may lower the blood lipid levels in pulmonary tuberculosis patients, and carrying ApoE ε2/ε3 genotypes and ε2 allele population has a higher risk of developing pulmonary tuberculosis.

Key words: Tuberculosis, pulmonary, Apolipoproteins E, Genes, Polymorphism, single nucleotide, Dyslipidemias