J Korean Med Sci.  2019 Oct;34(40):e269. 10.3346/jkms.2019.34.e269.

The Association between the Apolipoprotein E Gene Polymorphism and All-cause Mortality in the Korean Population

  • 1Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea. mhshinx@paran.com
  • 2Department of Preventive Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea.
  • 3Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
  • 4Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Korea.
  • 5Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea.
  • 6Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.


Apolipoprotein E (APOE) gene polymorphism is associated with neurodegenerative and cardiovascular diseases. Although the effects of the gene differ by ethnic group, few studies have examined Asians. Therefore, the association between APOE polymorphism and mortality in Koreans was evaluated in this study.
This study population included participants from the Dong-gu and Namwon Studies. APOE genotypes were categorized as E2 (E2/E2 and E2/E3), E3 (E3/E3), and E4 (E3/E4 and E4/E4). Multivariate Cox proportional hazard models were constructed using the E3 allele as a reference.
In the model adjusting for study site, age, gender, and lifestyle, the hazard ratio (HR) of mortality for those with the E4 allele was 1.08 (95% confidence interval [CI], 0.97-1.20), while that for those with the E2 allele was 0.84 (95% CI, 0.74-0.96). After adjusting for blood lipids to evaluate their mediating effects, the HRs of mortality for those with E4 and E2 alleles were 1.08 (95% CI, 0.97-1.20) and 0.80 (95% CI, 0.70-0.92), respectively. These associations were more evident in younger groups, with HRs of 0.70 (95% CI, 0.52-0.92) for the E2 allele and 1.25 (95% CI, 1.03-1.53) for the E4 allele.
In two large population-based cohort studies, the E2 allele was associated with a lower risk of mortality compared with the E3 allele, whereas the E4 genotype was not associated with mortality in Koreans.


Apolipoprotein E Cohort Studies; All-cause Mortality; Polymorphism
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