Publication: Apolipoprotein E gene polymorphism: effects on plasma lipids and risk of type 2 diabetes and coronary artery disease
Issued Date
2012
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
Cardiovascular Diabetology. Vol. 11, (2012), 36
Suggested Citation
Rajesh Chaudhary, Atip Likidlilid, Thavatchai Peerapatdit, Damras Tresukosol, Sorachai Srisuma, Suphachai Ratanamaneechat, Charn Sriratanasathavorn Apolipoprotein E gene polymorphism: effects on plasma lipids and risk of type 2 diabetes and coronary artery disease. Cardiovascular Diabetology. Vol. 11, (2012), 36. doi:10.1186/1475-2840-11-36 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2647
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Title
Apolipoprotein E gene polymorphism: effects on plasma lipids and risk of type 2 diabetes and coronary artery disease
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Abstract
Background: The most common apolipoprotein E (apoE) gene polymorphism has been found to influence plasma
lipid concentration and its correlation with coronary artery disease (CAD) has been extensively investigated in the
last decade. It is, however, unclear whether apoE gene polymorphism is also associated with increased risk of type
2 diabetes mellitus (T2DM). The knowledge of this study may provide the primary prevention for T2DM and CAD
development before its initiation and progression. Therefore, this study was carried out to determine the
association between apoE gene polymorphism and T2DM with and without CAD and its role in lipid metabolism.
Methods: The case-control study was carried out on a total of 451 samples including 149 normal control subjects,
155 subjects with T2DM, and 147 subjects with T2DM complicated with CAD. The apoE gene polymorphism was
tested by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Univariable and
multivariable logistic regression analyses were used to identify the possible risks of T2DM and CAD.
Results: A significantly increased frequency of E3/E4 genotype was observed only in T2DM with CAD group (p =
0.0004), whereas the ε4 allele was significantly higher in both T2DM (p = 0.047) and T2DM with CAD (p = 0.009) as
compared with controls. E3/E4 genotype was also the independent risk in developing CAD after adjusting with
established risk factors with adjusted odds ratio (OR) 2.52 (95%CI 1.28-4.97, p = 0.008). The independent predictor
of individuals carrying ε4 allele still remained significantly associated with both CAD (adjusted OR 2.32, 95%CI 1.17-
4.61, p = 0.016) and T2DM (adjusted OR 2.04, 95%CI 1.07-3.86, p = 0.029). After simultaneously examining the joint
association of E3/E4 genotype combined with either obesity or smoking the risk increased to approximately 5-fold
in T2DM (adjusted OR 4.93, 95%CI 1.74-13.98, p = 0.003) and 10-fold in CAD (adjusted OR 10.48, 95%CI 3.56-30.79,
p < 0.0001). The association between apoE genotypes on plasma lipid levels was compared between E3/E3 as a
reference and E4-bearing genotypes. E4-bearing genotypes showed lower HDL-C and higher VLDL-C and TG,
whereas other values of plasma lipid concentrations showed no significant difference.
Conclusions: These results indicate that ε4 allele has influence on lipid profiles and is associated with the
development of both T2DM with and without CAD, and furthermore, it increased the risk among the subjects with
obesity and/or smoking, the conditions associated with high oxidative stress.