Influence of 6 genetic variants on the efficacy of statins in patients with dyslipidemia

J Clin Lab Anal. 2018 Oct;32(8):e22566. doi: 10.1002/jcla.22566. Epub 2018 May 7.

Abstract

Background: Patients with dyslipidemia are often treated with statins to reduce lipids and hence cardiovascular risk, but treatment response is variable, partly due to genetic factors.

Methods: We studied the influence of 6 gene variants (APOE c.526C > T (APOE2), APOE c.388T > C (APOE4), SLCO1B1 c.521T > C, CYP3A4 c.-392G > A, HMGCR c.1564-106A > G, and LPA c.3947 + 467T > C) on statin efficacy assessing 2 indicators: the percent reduction in total cholesterol (TC) and non-HDL cholesterol (non-HDL), as well as the achievement of therapeutic goals. The study was performed in a group of patients (n = 100) without previous pharmacological treatment. Multiple regression models were used to calculate the percentage of explanation in response variability added by every variant to a basal model constructed with significant nongenetic control variables.

Results: The most influential variant was HMGCR c.1564-106A > G (rs3846662), and carriers showed a significantly lower reduction in TC and non-HDL. This variant is related to an alternative splicing involving exon 13, which is also regulated by lipid concentrations in patients without the variant. Concerning therapeutic goals, HMGCR c.1564-106A > G hindered the achievement of TC targets on patients.

Conclusions: The HMGCR c.1564-106A > G variant was associated with less statin efficacy to decrease cholesterol.

Keywords: dyslipidemia; genetic variants; non-HDL cholesterol; statins; total cholesterol.

MeSH terms

  • Adult
  • Cholesterol / blood*
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / genetics*
  • Female
  • Humans
  • Hydroxymethylglutaryl CoA Reductases / genetics*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide / genetics*
  • Regression Analysis
  • Treatment Outcome

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol
  • HMGCR protein, human
  • Hydroxymethylglutaryl CoA Reductases