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Small babies receive the cardiovascular protective apolipoprotein ε2 allele less frequently than expected
  1. C Infante-Rivard1,
  2. E Lévy2,
  3. G-E Rivard3,
  4. M Guiguet4,
  5. J-C Feoli-Fonseca2
  1. 1Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Canada
  2. 2Research Centre, CHUME Sainte-Justine, Université de Montréal, Montréal, Canada
  3. 3Hematology, CHUME Sainte-Justine, Université de Montréal, Montréal, Canada
  4. 4INSERM, U535-IFR69, Le Kremlin-Bicêtre, Paris, France
  1. Correspondence to:
 Dr C Infante-Rivard, Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, 1130 Pine Avenue West, Montréal, Québec, Canada, H3A 1A3; 

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A newborn whose weight for gestational age and sex is less than expected, based on population standards, is considered as having intrauterine growth restriction (IUGR); a cut off at less than the 10th centile is often used to define IUGR. Causes of IUGR remain unclear although a number of fetal and maternal risk factors have been identified.1,2 Increased early morbidity and mortality, as well as, possibly, less than optimal neuropsychological development, have been reported as consequences of IUGR.2,3 In addition, small size at birth has been associated with health problems in adulthood such as coronary heart disease and dyslipidaemia.4,5 The association between restricted fetal growth and adult chronic diseases (often referred to as the Barker hypothesis) is now considered robust and possibly causal.6

Apolipoprotein E (apoE) is one of the key regulators of plasma lipid levels as it affects hepatic binding, uptake, and catabolism of several classes of lipoproteins.7 The apolipoprotein E gene (APOE) codes for the apoE protein; in animal models, underexpression of the APOE gene and lack of the apoE protein result in increased susceptibility to atherosclerosis,8,9 whereas gene overexpression displays anti-inflammatory, antiproliferative, and atheroprotective properties.10 ApoE has also emerged as a central factor in various biological processes such as immunoregulation, control of cell growth and differentiation,11 and brain development.12 The three common allelic variants at the APOE locus (ε2, ε3, ε4) code for three major apoE protein isoforms (E2, E3, E4). These isoforms differ from one another only by single amino acid substitutions, yet these changes exhibit functional consequences at both the cellular and molecular levels.13,14 In previous studies, children who carry the ε4 allele and those who carry the ε2 allele have been shown to have, respectively, higher and lower total …

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