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Rheumatology Advance Access originally published online on August 24, 2004
Rheumatology 2004 43(12):1484-1487; doi:10.1093/rheumatology/keh383
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Rheumatology Vol. 43 No. 12 © British Society for Rheumatology 2004; all rights reserved

PAPER

Presence of apolipoprotein E {epsilon}4 allele predisposes to early onset of primary Sjögren's syndrome

M. Pertovaara, T. Lehtimäki1, R. Rontu1, J. Antonen1, A. Pasternack1 and M. Hurme1

Tampere University Hospital and 1 University of Tampere Medical School and Tampere University Hospital, Tampere, Finland.

Correspondence to: M. Pertovaara, Department of Internal Medicine, Section of Rheumatology, Tampere University Hospital, P.O. Box 2000, FIN-33521 Tampere, Finland. E-mail: marja.pertovaara{at}pshp.fi

Background. Apolipoprotein E (apoE) polymorphism plays a central role in lipid metabolism, but has recently also been suggested to regulate inflammation, as judged by levels of serum C-reactive protein (CRP).

Objective. To establish whether polymorphism of the apoE genes affects susceptibility to primary Sjögren's syndrome (pSS), degree of inflammation or age of onset of pSS.

Methods. ApoE genotype distribution and allelic frequencies were analysed using PCR and the TaqMan system in 63 Finnish Caucasian patients with pSS and in 64 healthy controls matched for sex, ethnic origin and area of residence. The clinical and immunological data on the pSS patients were analysed in relation to the apoE genotypes.

Results. There was no difference between pSS patients and controls in apoE genotype and allelic frequencies. The apoE {epsilon}4 allele was significantly associated with early onset of pSS in the entire population and in female patients (Kaplan–Meier log rank test, P = 0.0407 and P = 0.0168, respectively). The average age (± S.D.) of onset of pSS in all apoE {epsilon}4 allele carriers was 46 ± 12 and in other genotypes it was 53 ± 10 yr (P = 0.031, t-test). ApoE polymorphism was not associated with signs of inflammation evaluated by such markers as concentration of plasma CRP, plasma interleukin-6, plasma TNF-{alpha}, immunoglobulin G and haemoglobin, or leucocyte count or ESR.

Conclusions. ApoE polymorphism does not affect susceptibility to pSS or levels of plasma inflammatory indices in patients with pSS. However, a clear association prevails between apoE {epsilon}4 and early onset of pSS.

KEY WORDS: Apolipoprotein E, Gene polymorphism, Primary Sjögren's syndrome, Age at disease onset


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