Carbohydrate intake modifies associations between ANGPTL4[E40K] genotype and HDL-cholesterol concentrations in White men from the Atherosclerosis Risk in Communities (ARIC) study

BackgroundCommon allelic variation in the angiopoietin-like 4 gene (ANGPTL4[E40K]) has been associated with low triglyceride (TG) and high HDL-C.ObjectiveWe examined whether dietary macronutrient intake modified associations between ANGPTL4[E40K] variation and TG and HDL-C in White men and women from the Atherosclerosis Risk in Communities study.DesignDiet was assessed by food frequency questionnaire. Intake of fat (total fat [TF], saturated fat [SF], monounsaturated fat [MUFA], polyunsaturated fat [PUFA], and n-3 PUFA) and carbohydrate were expressed as percentage of total energy intake. ANGPTL4 A allele carriers (n = 148 in men, 200 in women) were compared to non-carriers (n = 3667 in men, 4496 in women). Interactions were tested separately in men and women, adjusting for study center, age, smoking, physical activity, BMI, and alcohol intake.ResultsANGPTL4 A allele carriers had significantly greater HDL-C and lower TG than non-carriers (p ≤ 0.001). In all participants, carbohydrate intake was inversely associated with HDL-C and positively associated with TG, whereas TF, SF, and MUFA showed opposite associations with TG and HDL-C (p < 0.001). These relations were uniform between sex-specific genotype groups, with one exception. In men, but not women, the inverse association between carbohydrate and HDL-C was stronger in A allele carriers (β ± S.E. −1.80 ± 0.54) than non-carriers (β ± S.E. −0.54 ± 0.11, pinteraction = 0.04 in men and 0.69 in women; p 3-way interaction = 0.14).ConclusionsThese data suggest that ANGPTL4 variation and relative contributions of dietary fat and carbohydrate influence TG and HDL-C concentrations. In men, ANGPTL4 variation and dietary carbohydrate may interactively influence HDL-C.