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Purpose: Genetic variants in apolipoprotein A5 (APOA5) have been shown to be associated with triglyceride (TG) levels and to influence lipid responses to fibrate treatments in some populations.We evaluated the effect of the APOA5 gene-1131T>C promoter polymorphism on fasting baseline TG levels and lipid responses to rosuvastatin in Chinese patients with hypercholesterolaemia.Methods: The 386 patients, including 166 with familial hypercholesterolaemia (FH), with good adherence to rosuvastatin 10 mg daily, were genotyped for the APOA5-1131T>C polymorphism (rs662799).The lipid profile was examined before and after at least 4 weeks of therapy.Results: The genotype distributions of APOA5-1131T>C polymorphism were comparable in patients with and without FH with the minor allele frequency of 33.3% and 27.8%, respectively (P>0.05).The APOA5-1131T>C polymorphism was significantly associated with baseline TG levels in both FH and non-FH patients (Table 1).The frequency of the C variant allele was about 2-fold higher (35.6% vs.18.2%) in subjects with TG ≥ 1.7mmol/L (n=88) compared with those with TG <1.7mmol/L (n=108) in non-FH patients (P< 0.001).Similar results were observed in the FH patients (41.4% [n=95] vs.27.9% [n=64], P<0.01).There was no significant association between APOA5 genotype and any lipid response to rosuvastatin in patients with or without FH.However, in subjects with TG ≥ 1.7mmol/L, those with the-1131T>C variant allele showed greater increases in high-density lipoprotein cholesterol (HDL-C) with rosuvastatin (∏: TC: CC =1.4% vs.2.6% vs, 9.7%, P<0.05).This may be partly related to the lower baseline level of HDL-C in patients with the CC genotype.Conclusions: This study confirms the strong relation between the APOA5 polymorphism and baseline TG levels in Chinese patients, including those with FH who had relatively normal TG levels.Any influence of this polymorphism on HDL-C response to statin treatment is likely to be dependent on the baseline HDL-C level.