Background

The gene ApoE with the alleles e2, e3 and e4 has been associated with a range of disorders. This study aimed at exploring the prevalence rates of the e-alleles and the associations between the alleles and comorbidity and inflammatory biomarkers in subjects with morbid obesity.

Methods

Consecutive subjects 18-65 years of age with morbid obesity (defined as BMI ≥ 40 kg/m2 or ≥35 kg/m2 with obesity-related complications) referred to Innlandet Hospital Trust, Norway for evaluation of bariatric surgery were included in this cross-sectional study. Several psychosocial variables (physical activity, musculoskeletal pain, WHO-5 Well-being index, psychological distress (Hopkins Symptom Checklist 10), fatigue, Rosenberg self-esteem, Epworth sleepiness scale) were registered, and blood samples were analyzed for inflammatory markers.

Results

The study included 140 subjects (men/women: 32 (23%)/108 (77%) with mean age 43.0 (SD 8.7) years and BMI 42.1 (SD 3.8) kg/m2. The prevalence rates of the ApoE-e alleles were: e2e2: 1 (0.7%), e2e3: 13 (9.3%), e2e4: 4 (2.9%),e3e3: 71 (50.7%), e3e4: 47 (33.6%), and e4e4: 4 (2.9%). None of the e-alleles was associated with age, gender or BMI. In subjects with and without the e4-allele, CRP were 5.3 (SD 4.6) and 8.2 (SD 7.1) mg/L (p=0.004) respectively. Presence of the e2 allele was associated with better well-being (p=0.003) and reduction of musculoskeletal pain (p=0.020), psychological distress (p<0.001), fatigue (p=0.045) and sleepiness (p=0.057).

Conclusions

The prevalence rates of the ApoE alleles were as expected in the Norwegian population. The results indicate that ApoE e4 could be associated with reduced inflammatory related comorbidity such as cardiovascular disease and cancer, and that the presence of ApoE e2 increases well-being and protects against psychosocial comorbidity in subjects with morbid obesity.