A Long-Term Follow-Up Study on Disclosing Genetic Risk Information (APOE) to Promote Healthy Lifestyles in Finland

Hanna-Leena Hietaranta-Luoma; Maaria Tringham; Heli Karjalainen; Laura Tanner; Kirsi Vähäkangas; Anna-Maija Pietilä; Kari Åkerman; Hannu Puolijoki; Raija Tahvonen; Anu Hopia

doi:10.1159/000500199

A Long-Term Follow-Up Study on Disclosing Genetic Risk Information (APOE) to Promote Healthy Lifestyles in Finland

Lifestyle Genom. 2018;11(3-6):147-154. doi: 10.1159/000500199. Epub 2019 Jun 24.

Affiliations

¹ Functional Foods Forum, University of Turku, Turku, Finland.
² Functional Foods Forum, University of Turku, Turku, Finland, maaria.tringham@utu.fi.
³ Department of Clinical Genetics, Helsinki University Hospital, Helsinki, Finland.
⁴ School of Pharmacy/Toxicology, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
⁵ Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
⁶ Central Hospital of Southern Ostrobothnia, Seinäjoki, Finland.
⁷ Production Systems, Natural Resources Institute Finland (Luke), Jokioinen, Finland.

PMID: 31234179
DOI: 10.1159/000500199

Abstract

Aim: This observational follow-up study was designed to assess the long-term behavioural and clinical effects of receiving personal genetic risk information. The information disclosed was the carrier status of the apolipoprotein E (APOE)alleles, which differentially contribute to the genetic risk for cardiovascular disease (CVD) and Alzheimer's disease.

Methods: This study forms a continuum with a previous 1-year intervention (2010-2011) monitoring the effects of disclosing the carrier status of the APOE ε4risk allele. The follow-up measurements, performed 5.5 years post-intervention, included clinical measurements (blood values and anthropomorphic parameters) and questionnaires (psychological and behavioural factors). The participants were healthy adult volunteers, aged 26-73 years (n = 70) who had participated in the previous intervention, and received their APOE allele status either at the beginning (former test group) or the end of the intervention (former control group).

Results: Personal genetic risk information resulted in a moderate health-conscious change in diet and had a slight positive long-term effect on clinical factors, particularly the serum lipids. These improvements were subsequent to the disclosure of genetic information and occurred mainly in the APOE ε4-positive members of the former control group, that is, those who were at increased genetic risk for CVD but had not been informed of their status before the end of the intervention. In contrast, changes in the values and health behaviour of the APOE ε4-positive individuals in the former test group, who had already changed their health behaviour during the previous intervention as a result of being informed of their carrier status, varied more: some continued to improve, some remained at their previously improved level, and some relapsed slightly. Both groups had nonetheless displayed an improvement immediately subsequent to the disclosure of their personal genetic risk.

Conclusion: Receiving information on increased personal genetic risk (carrier status of APOE ε4)for CVD provided the motivation for improvements in health behaviour. The resulting changes, while modest, in most cases remained visible even after a number of years.

Keywords: APOE; Disclosing genetic information; Genotyping; Lipid metabolism; Motivation for lifestyle change; Nutrigenetics; Public health and preventive medicine.