Analysis of the association between SLCO1B1 gene polymorphisms and coronary heart disease risk in southern Han Chinese population and statin responses in the elderly.

OBJECTIVE

Research on SLCO1B1 polymorphisms and statin therapy in elderly patients is limited and controversial. This study explored the association of SLCO1B1 c.521T>C and c.388A>G variants with coronary heart disease (CHD) risk, and evaluated the lipid-lowering efficacy and safety of standard-dose statins in subjects aged >75 years to provide evidence for geriatric clinical statin use.

METHODS

A retrospective cohort study analyzed 6,146 individuals who were genotyped SLCO1B1 variants c.521T>C and c.388A>G. 2318 participants were selected to evaluate the prevalence of diseases. 118 subjects (>75 years) were categorized into statin-treated (n = 57) and control (n = 61) groups. Lipid indices, liver function tests and muscle injury marker were measured by standard techniques.

RESULTS

The SLCO1B1 c.521C allele was independently associated with increased CHD risk (odds ratio [OR] = 1.37, 95% CI:1.06-1.77, P = 0.02). Statin therapy significantly reduced total cholesterol (TC: 3.70 ± 0.88 vs. 4.18 ± 0.84 mmol/L, P = 0.004) and low-density lipoprotein cholesterol (LDL-C: 1.88 ± 0.70 vs. 2.17 ± 0.61 mmol/L, P = 0.04) without elevating hepatic transaminases or creatine kinase (P > 0.05). Carriers of the c.388A allele exhibited greater TC/LDL-C reductions compared to c.388GG homozygotes (P < 0.05), whereas the c.521T > C polymorphism showed no significant impact on therapeutic efficacy or safety outcomes.

CONCLUSIONS

The SLCO1B1 c.521C allele represents an independent genetic marker for CHD susceptibility in the southern Han Chinese population. In geriatric populations, standard-dose statin therapy maintains lipid-lowering efficacy and safety, unaffected by the SLCO1B1 c.521T>C polymorphism. Our findings provide a genetic screening tool for the primary prevention of cardiovascular diseases and offer support for the efficacy and safety of statin-based lipid-lowering therapy in adults aged >75 years.