Apolipoprotein E gene and retinal microvascular signs in older people: The cardiovascular health study

Purpose: To examine the association between apolipoprotein E (APOE) gene polymorphism and retinal microvascular, sign in an older population. Methods: Retinal photographs were taken of 2,152 participants (1,831 whites, and 321 African-Americans), aged 69-96 years, who were participating in a population-based study of four United States communities. We used standardized protocols to assess photographs for the presence of retinal microvascular signs (retinopathy, arterio-venous nicking, and focal arteriolar narrowing) and a computer-assisted method to measure retinal vessel diameters. We analyzed DNA extracted from blood samples of participants for common allelic variants of the APOE gene. Results: After adjusting for age, gender, systolic blood pressure, smoking, total serum cholesterol, and other risk factors, we found white participants carrying the ε2 and ε4 alleles were more likely to have arterio-venous nicking than the ε3/ε3 homozygotes, with odds ratio (OR) of 1.70 and confidence interval (0) 95% (1.03-2.83) for the ε2 carriers and OR 1.74 (95% CI 1.06-2.84) for the ε4 carriers. Among white participants without hypertension, the associations remained significant for the ε4 carriers (OR 2.32, 95% CI 1.18-4.57). Whites, normotensive carriers of the ε2 allele had significantly narrower retinal arteriolar diameters (adjusted mean arteriolar diameter of 163.5 μm, 95% CI 160.1-167.0, p-0.03) compared to the ε3/ε3 homozygotes (167.8 μm, 95% CI 166.0-169.6). APOE gene polymorphisin was not associated with retinopathy, focal narrowing, or retinal venular diameters in white participants. There were insufficient numbers of African-Americans for separate multivariate analysis. Conclusions: This study provides little evidence that the APOE gene polymorphism plays a significant role in the patho-genesis of retinal microvascular changes in the general population. In the older white population, APOE ε2 and ε4 allele carriers were more likely to have arterio-venous nicking. Other retinal signs, however were not related to APOE gene polymorphism.