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Apolipoprotein E (Apo E) genotyping

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  • Apolipoprotein E (Apo E) genotyping
Created: 10/03/2024
Edited: 10/03/2024
Written by: Carlota Pano

What is analysed?

Apolipoprotein E (Apo E) is a protein that helps transport lipids (fat) and cholesterol.

There are several isoforms (variants) of the Apo E protein, but three major ones - Apo E2, Apo E3, and Apo E4 - are most commonly found in humans. Everyone possesses a pair of Apo E genes that forms different combinations, for example E3/E3, E2/E4 etc.

Apo E genotyping is an analysis that examines specific variations in the APOE gene.

What does the result mean?

The result indicates which isoform of the APOE gene a patient carries.

Specific and different combinations of isoforms are associated with varying risks for cardiovascular and neurodegenerative conditions.

Why conduct the analysis?

Apo E genotyping is conducted to help diagnose Type III hyperlipoproteinaemia, a rare genetic disorder that affects lipid metabolism, leading to abnormal elevations in cholesterol and triglyceride levels in the blood.

When to conduct the analysis?

Apo E genotyping is conducted in various clinical scenarios:

  • When high cholesterol and triglyceride concentrations are suspected to be caused by a genetic disorder.
  • When types of xanthomas (raised yellow patches) on the skin are observed. 

What sample is required?

A blood sample is required. The blood is taken from a vein, usually in the arm.

Is any prior preparation necessary?

No prior preparation is required.

How is it performed?

The sample is sent to a laboratory, where it is analysed using molecular techniques such as polymerase chain reaction (PCR) and DNA sequencing to identify the specific isoform of the Apo E gene.

What does having altered values mean?

APOE genotype Interpretation
APO E2/E2 Increased risk for cardiovascular and Alzheimer's diseases
APO E2/E3 Moderate risk for cardiovascular and Alzheimer's diseases
APO E2/E4 Increased risk for cardiovascular and Alzheimer's diseases
APO E3/E3 Balanced profile, average risk for cardiovascular and Alzheimer's diseases
APO E3/E4 Moderate risk for cardiovascular and Alzheimer's diseases
APO E4/E4 Increased risk for cardiovascular and Alzheimer's diseases
  • Apo E2: Apo E2 is less able to remove lipids from the bloodstream compared to the other isoforms and is associated with a higher risk for early cardiovascular disease.
  • Apo E3: Apo E3 is considered to be ‘neutral’, representing a common and balanced profile with average risks for cardiovascular and neurodegenerative conditions.
  • Apo E4: Apo E4 is associated with an increased risk of cardiovascular diseases and a higher risk of developing Alzheimer's disease.
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