APOA5-1131T>C genotype effects on apolipoprotein A5 and triglyceride levels in response to dietary intervention and regular exercise (DIRE) in hypertriglyceridemic subjects

ObjectiveWe aimed to determine the influence of apolipoprotein A5 gene (APOA5)-1131T>C single nucleotide polymorphism on the effects of dietary intervention and regular exercise (DIRE) targeting ApoA5 and triglyceride (TG) concentrations.MethodsHypertriglyceridemia patients (TG, 150–500 mg/dL, n = 283) undertook a 12-week DIRE (replacing 1/3 of refined rice in their diets with legumes, increasing vegetable intake, and regular walking).ResultsPre-treatment, no genotype-related differences were detected in ApoA5, TG, or HDL cholesterol levels; however, post-treatment, subjects homozygous (T/T) for the T allele had lower serum TG (P = 0.009) and higher HDL cholesterol (P = 0.036) than other subjects. In T/T subjects, after adjustments for age, sex and weight changes (r1) or initial TG levels (r2), changes in ApoA5 levels negatively correlated with TG changes (r1 = −0.29, P = 0.05, r2 = −0.28, P < 0.1) and positively correlated with changes in HDL cholesterol (r1 = 0.30, P < 0.05, r2 = 0.32, P < 0.05) and free fatty acid (r1 = 0.38, P < 0.01, r2 = 0.40, P < 0.01). In those with moderate hypertriglyceridemia (TG, 200–500 mg/dL, n = 130), APOA5-1131T/T carriers achieved significantly lower TG (P = 0.007) and higher HDL cholesterol (P < 0.001) than −1131C allele carriers. Additionally, statistically significant interactions between the −1131T>C and the compliance of DIRE were found for the change in TG (P = 0.002) and HDL cholesterol (P = 0.039). In good compliance group, T/T subjects showed greater reduction of TG and higher increase of HDL cholesterol than other subjects. On the other hand, non-good compliance group had no significant improvement in these variables.ConclusionsAPOA5-1131T/T carriers may benefit more from the DIRE than C allele carriers. These effects were remarkable in patients with moderate hypertriglyceridemia and the individuals with good compliance.