Investigation of the relationship between serum LDL cholesterol levels with genetic polymorphisms, gut microbiota and nutrition

In order to prevent cardiovascular diseases (CVD), which is the all-cause mortality in the world today, it is important to determine the factors that are effective in its development. High serum LDL cholesterol (LDL-C) levels are a modifiable prevention and treatment target known to contribute to the development of CVD, but the factors affecting blood cholesterol levels, including LDL-C, are highly controversial. In the current study, the factors thought to be effective on LDL-C levels in the blood were discussed with a holistic perspective, and the effects of the relationship between these factors on LDL-C levels were examined. The study was carried out with 609 (48% male) adults who applied to a private health institution between 2016-2022. Serum LDL-C levels, anthropometric measurements, food frequency records, genetic information and gut microbiota characteristics of individuals were obtained from patient registry files. As a result of the research, it was observed that serum LDL-C levels were positively correlated with body mass index (BMI) (p=0.000) and different ApoE alleles had significant effects on LDL-C levels. Results showed that individuals in the ε4+ group had the highest serum LDL-C levels according to the ApoE allele groups, followed by the ε3/ε3 group, and the individuals in the ε2+ group had the lowest serum LDL-C levels (p=0.000). The study observed that the amount of dietary cholesterol and dietary fiber consumption did not have significant effects on serum LDL-C levels (p=0.705, p=0.722, respectively). When the intestinal characteristics were examined, it was observed that enterotypes and the butyrate synthesis potential of the intestinal microbiota did not cause significant changes in serum LDL-C levels (p=0.369, p=975, respectively). In addition, no significant effects of gene-nutrient or microbiota-nutrient interactions on serum LDL-C levels were detected. The present study shows that ApoE gene polymorphisms have an effect on serum LDL-C levels, while nutritional and microbiota characteristics do not cause a similar effect. Keywords: LDL-C, Cholesterol, ApoE, Nutrigenetics, Gut Microbiota