
ROLE OF THE APOB GENE POLYMORPHISM (c.12669G>A,
p.Gln4154Lys) IN CORONARY ARTERY DISEASE IN
THE INDIAN PUNJABI POPULATION Sharma R1,*, Mahajan M2, Singh B1, Singh G3, Singh P3 *Corresponding Author: Ritu Sharma, Department of Biochemistry, Government Medical College, Circular
Road, Amritsar-143001, Punjab, India; Tel.: +91-183-257-3637; Fax: +91-183-242-6506: E-mail: ritu_gmc@
rediffmail.com page: 35
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MATERIAL AND METHODS
We recruited 87 CAD patients from the Out Patient
Departments and Medical Wards of the Employee’s
State Insurance (ESI) and Guru Nanak Dev
hospitals, Amritsar, India, diagnosed with CAD by the
clinician on the basis of clinical symptoms, echocardiogram
(ECG), changes, stress test and angiography
(if required). Seventy-four healthy individuals without
any evident symptoms of CAD and any past history
of the disease, were taken as controls from the general
population. Subjects were segregated into males and
females and divided into three age groups: 35-45, 46-
55 and 56-65 years. A written informed consent was
signed by each individual. A detailed questionnaire
was prepared for all the necessary details of both patients
and control subjects to answer. Coronary artery
disease patients suffering from diabetes mellitus, renal
or thyroid disease, rheumatoid arthritis, acute infections,
on lipid lowering medications or women on oral
contraceptives or who had undergone hysterectomy
were excluded.
Venous blood samples were taken after 12-hour
overnight fasting. Serum was used for various biochemical
investigations. High-density lipoprotein (HDL) was
isolated from serum by precipitating LDL and very lowdensity
lipoprotein (VLDL) with magnesium chloride
and sodium phosphotungstate reagent [14]. Total cholesterol
and HDL cholesterol levels were estimated by
extracting it quantitatively into acetone-ethanol mixture.
The cholesterol residue was dissolved in glacial acetic
acid and allowed to react with concentrated sulphuric
acid and ferric chloride reagent [15]. Serum triglycerides
were estimated using a commercially available kit from
Biotech, Baroda, Gujrat, India [16]. The LDL cholesterol
levels were calculated from the formula given by
Friedwald et al. [17]. Serum apoB levels were estimated
using an immunoturbidimetric kit (Diasys, Holzheim,
Germany). The LDL was isolated from serum. Briefly,
the precipitation buffer consisted of 0.064 M trisodium
citrate adjusted to pH 5.05 and contained 50,000 IU/L
heparin. The insoluble lipoproteins were sedimented
by centrifugation at 1,000g for 10 min. The pellet was
resuspended in 1 mL of 0.1 M sodium phosphate buffer
at pH 7.4 containing 0.9% normal saline [18]. The
LDL protein oxidation as apoB carbonyl content was
assessed. Briefly, 0.2 mL of dinitrophenylhydrazine
(10 mM DNPH in 2 M HCl) was added to the isolated
LDL solution in a centrifuge tube. The contents were
incubated for 1 hour at room temperature. Then 0.6 mL
of denaturing buffer (0.15 M sodium phosphate buffer,
pH 6.8, containing 3% sodium dodecyl sulphate) was
added and the tubes were allowed to vortex for 1min.
After mixing, an equal volume of ethanol and heptane
mixture was added and the contents were mixed again.
The tubes were centrifuged at 1,000 g for 5 min. The
LDL was recovered from the interface and washed three
times with ethanol ethyl acetate (1:1 v/v) mixture. Each
DNPH sample was dissolved in denaturing buffer and
was scanned from 320 to 410 nm. The peak absorbance
was used to calculate protein carbonyls with extinction
coefficient 22,000 M–1 cm–1 [19]. Results were expressed
as nmoles carbonyl/mg LDL protein. The LDL
lipid peroxidation as malondialdehyde (MDA) levels
was estimated by the method of Beuge and Aust [20].
The protein content of the LDL sample was estimated
according to the protocol of Lowry et al. [21].
DNA was isolated from the blood samples by the
phenol chloroform method [22] and the quality was checked on 0.8% agarose gel electrophoresis. DNA
amplification kits and primers were procured from Genei,
Bangalore, India. A 480 bp sequence of APOB gene
containing the EcoR1 restriction site was amplified by
polymerase chain reaction (PCR) on a thermal cycler
(Bio-Rad India Pvt Ltd., Gurgaon, India). The following
primers were used to amplify the desired sequence
in APOB gene: forward primer (F) 5’-CTG AGA GAA
GTG TCT TCG AAG-3’ and reverse primer (R) 5’-
CTC GAA AGG AAG TGT AAT CAC-3’. The reaction
mixture was prepared to a final volume of 50 μL; 2 μL
of DNA (1 μg/μL) was added to the assay mixture. The
amplified sequence was isolated after 0.8% agarose gel
electrophoresis and digested overnight at 37°C with 20
U of EcoR1. The digested products were resolved on
2.5% agarose gel electrophoresis in 1X Tris-acetate
ethylenediaminetetraacetic (TAE) buffer, pH 8.0, at a
constant voltage of 50 V. A 480 bp sequence containing
the EcoR1 restriction site was digested into fragments
of 253 and 227 bp, respectively. In the absence of the
EcoR1 restriction site, the 480 bp sequence produced
only a single band on the agarose gel. The respective
alleles were designated as R+ and R–.
Stastistical Analysis. Results were expressed as
mean ± standard deviation (SD). Chi-Square was applied
to determine the significance in allele frequency.
The Student’s t test was applied to assess the significance
in other parameters. Statistical significance was
determined at p <0.05.
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