Abstract: Objectives: We analyzed the correlation between osteoporosis and carotid atherosclerosis (CA) by exploring the effects of ApoE gene polymorphisms on bone mineral density (BMD) of the lumbar spine and CA. Design and methods: We selected 221 elderly Han male patients and divided them into four groups: control, CA, BMD↓, and CA+BMD↓ according to their carotid ultrasonography and lumbar BMD results. ApoE gene polymorphisms were examined in each group. Results: The CA group had a higher incidence of ApoE4 isoforms compared to normal controls (P<0.05). The ApoE4 isoform incidence in the BMD↓ and BMD↓/CA groups showed no significant difference from control. ApoE4 genotype incidences in the CA group, BMD ↓ group, and CA/BMD ↓ group were not significantly different. Conclusion: The ApoE4 genotype may be a risk factor for carotid atherosclerosis, but is not correlated with bone mineral density (BMD) in the lumbar spine in elderly Han males. [Copyright &y& Elsevier]