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Copyright ©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2026; 18(1): 113327
Published online Jan 26, 2026. doi: 10.4330/wjc.v18.i1.113327
Deciphering Teochew population’s genetic protective barrier: Apolipoprotein E- lipoprotein(a) kringle IV type 2 synergy as novel cardioprotective pathway
Ru-Tong Wang, Ying-Qi Feng, Si-Qi Tu, Shen Yang
Ru-Tong Wang, Ying-Qi Feng, Si-Qi Tu, Shen Yang, Department of Neurology, The First People’s Hospital of Xiangtan City, Xiangtan 411100, Hunan Province, China
Ru-Tong Wang, Ying-Qi Feng, Si-Qi Tu, Clinical Anatomy and Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang 421001, Hunan Province, China
Co-first authors: Ru-Tong Wang and Ying-Qi Feng.
Author contributions: Wang RT and Feng YQ contributed to data organization, and they contributed equally to this manuscript as co-first authors; Wang RT, Feng YQ, and Tu SQ contributed to investigation and original draft the manuscript; Wang RT and Yang S contributed to conceptualization; Wang RT contributed to data curation, resources, and formal analysis; Yang S contributed to methodology, project administration, supervision, and revied and edited the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shen Yang, MD, PhD, PsyD, Academic Fellow, Chief, Department of Neurology, The First People’s Hospital of Xiangtan City, No. 100 Shuyuan Road, Yuetang District, Xiangtan 411100, Hunan Province, China. doctoryangshen@163.com
Received: August 22, 2025
Revised: September 16, 2025
Accepted: November 25, 2025
Published online: January 26, 2026
Processing time: 146 Days and 11.7 Hours
Core Tip

Core Tip: This study identifies a novel synergistic cardiometabolic protective pathway in the genetically distinct Teochew (Chaozhou) Han population of southern China. We demonstrate that the co-presence of the apolipoprotein E (APOE) ε2 allele and high copy number variation of the lipoprotein(a) kringle IV type 2 gene significantly reduces coronary heart disease risk, contrasting with previous reports on APOE ε2 in Asians. This unique gene-environment interaction, potentially modulated by the local seafood-rich diet, offers a population-specific biomarker for optimized coronary heart disease risk stratification. Clinical translation emphasizes integrating APOE/lipoprotein(a) kringle IV type 2 copy number variation screening with solute carrier organic anion transporter family member 1B1 pharmacogenetics to guide precision statin therapy and personalized prevention strategies.