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Apoprotein E phenotype determines serum cholesterol in infants during both high-cholesterol breast feeding and
M J Kallio1, L Salmenperä, M A Siimes
1Department of Medicine, University of Helsinki, Finland.
Insights
Infant apolipoprotein E (apoE) phenotype influences cholesterol levels, particularly with high-fat diets. The apoE4 phenotype is linked to higher serum and LDL cholesterol in infants fed human milk.
Area of Science:
- Biochemistry
- Pediatrics
- Genetics
Background:
- Serum lipid profiles in infants are influenced by genetic factors and diet.
- Apolipoprotein E (apoE) phenotype is a key genetic determinant of lipid metabolism.
- Early life nutrition, including human milk and formula, plays a critical role in infant development.
Purpose of the Study:
- To investigate the association between apolipoprotein E (apoE) phenotype and serum lipid concentrations in infants.
- To compare these associations in infants fed high-fat, high-cholesterol human milk versus low-cholesterol, high-unsaturated fat formula.
- To determine the impact of apoE genotype on cholesterol and apoB levels during the first year of life.
Main Methods:
- Quantification of total and lipoprotein cholesterol, apoB, and triglyceride concentrations in serum from 151 infants.
- Categorization of infants into apoE phenotype groups (E4, E3, E2).
- Longitudinal analysis of lipid parameters at birth and at 2, 6, 9, and 12 months of age.
Main Results:
- Infants with the apoE4 phenotype exhibited significantly higher serum and LDL cholesterol concentrations compared to E3 and E2 groups when fed high-fat, high-cholesterol human milk.
- Increases in LDL cholesterol and LDL apoB mirrored total cholesterol trends.
- Dietary differences were noted, with smaller variations between apoE groups in formula-fed infants.
Conclusions:
- The apoE phenotype, particularly the E4 variant, significantly modulates serum and LDL cholesterol levels in infants consuming high-fat, high-cholesterol human milk.
- These findings highlight the interplay between genetics and diet in early-life lipid metabolism.
- Further research is warranted to understand long-term implications of these early-life variations.
Abstract:
Our objective was to establish the role of the apoprotein (apo) E phenotype in determining serum cholesterol levels in infants fed exclusively on high-fat, high-cholesterol human milk and in those fed a low-cholesterol, high-unsaturated fat formula. The total and lipoprotein cholesterol, apoB, and triglyceride concentrations in serum were quantified and related to the apoE phenotype in 151 infants at birth and at 2, 6, 9, and 12 months of age. Forty-four had the E3/4 or 4/4 phenotype (E4 group), 94 had the E3/3 phenotype (E3 group), and 13 had the E2/3 or 2/4 phenotype (E2 group). In cord blood, cholesterol concentrations tended to be higher in the E4 than in the E2 group. With exclusive breast-feeding, the concentrations rose significantly faster and higher in the E4 group than in the E3 group or, especially, the E2 group. The values (mmol/L, mean +/- SEM) were 1.6 +/- 0.15, 1.5 +/- 0.05, 1.4 +/- 0.1 (P = n.s.) at birth; 4.2 +/- 0.1, 3.8 +/- 0.08, 3.4 +/- 0.2 (P < 0.001) at 2 months; 4.4 +/- 0.15, 3.9 +/- 0.1, 3.4 +/- 0.15 (P < 0.001) at 4 months; 4.3 +/- 0.17, 4.0 +/- 0.13, 3.7 +/- 0.26 (P < 0.001) at 6 months; 4.8 +/- 0.28, 4.4 +/- 0.11, 3.8 +/- 0.05 (P < 0.001) at 9 months; and 4.7 +/- 0.11, 4.4 +/- 0.08, 4.1 +/- 0.19 (P < 0.001) at 12 months, for the E4, E3, and E2 groups, respectively. Increases in LDL cholesterol and LDL apoB behaved similarly. The total triglyceride, and total HDL, HDL2, and HDL3 cholesterol concentrations did not depend on the apoE phenotype. Among infants fed high-fat, high-cholesterol human milk, the total and LDL-cholesterol concentrations and the LDL apoB concentration of those with the apoE phenotype 4/4 or 3/4 rose faster and to higher levels than in other infants. Among formula-fed infants, receiving a low-cholesterol, high-unsaturated fat diet, the differences between the apoE groups were smaller.