Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males.

To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3).

Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3±30.5 mg/dL vs. 181.3±33.4 mg/dL, p<0.001;TG 131.0±62.9 mg/dL vs. 149.4±76.7 mg/dL, p=0.023;HDLc 56.0±11.0 mg/dL vs. 56.9±11.5 mg/dL, p=0.509;LDLc 92.5±28.1 mg/dL vs 100.6±29.9 mg/dL, p=0.016;Lp (a) 22.1±14.6 mg/dL vs. 26.9±13.8 mg/dL, p=0.004;FBS 85.1±14.1 mg/dL vs. 102.7±16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group.

Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.