Association of Apolipoprotein E Polymorphisms and Risks of Ischemic Stroke in Chinese Patients with Type 2 Diabetes Mellitus

Relationships of apolipoprotein E genotypes with a cluster of seven in persons with type 2 diabetes

OBJECTIVE.

The objective of the study was to determine if there would be statistically significant differences or trends among apolipoprotein E genotypes (2/2, 2/3, 2/4, 3/3, 3/4, and 4/4) for each member of the cluster of seven associated with type 2 diabetes (T2D). The cluster of seven includes abdominal obesity, hypertension, platelet hyperaggregability, hyperglycemia, dyslipidemia (decreased plasma levels of high-density lipoprotein cholesterol (HDL-C) and increased plasma levels of triglycerides)), increased low-density lipoprotein (LDL) oxidation, and increased inflammation.

METHODS.

Forty-six patients with well-controlled T2D participated in the study. Abdominal obesity (assessed by waist circumference), hypertension (measured by manual sphygmomanometry), platelet hyperaggregability (measured by bleeding time), hyperglycemia (by enzymatic kit and spectrophotometry), decreased plasma levels of HDL-C and increased plasma levels of triglycerides (by enzymatic kit and spectrophotometry), increased LDL oxidation (measured by LDL conjugated dienes using spectrophotometry) and increased inflammation measured by C-reactive protein (CRP) (by EIA kit) were determined.

RESULTS.

All genotypes, except 2/2 were found in the population studied. Abdominal obesity did not vary significantly across the five genotypes. However, glucose levels trended progressively higher going from 2/3 to 2/4 to 3/4 to 4/4. Systolic blood pressure was higher in 3/4 compared to 2/4 and trended higher in 3/4 compared to 3/3. Diastolic blood pressure trended higher in 3/3 vs 2/4 and significantly higher in 3/4 compared to 2/4. Triglycerides trended higher in 3/4 vs 3/3 while HDL-C came close to trending downward in 4/4 compared to 2/4. Bleeding time was unaffected by genotype. Plasma LDL conjugated dienes trended higher in 3/4 vs 2/4 and were significantly higher in 3/4 vs 3/3. CRP trended higher in 4/4 vs 2/3.

CONCLUSION.

We can conclude that those with at least one 4 allele in the presence of another allele being 2, 3 or 4 is potentially (in the case of trends) deleterious or is deleterious in terms of hyperglycemia, hypertension (systolic and diastolic blood pressure), dyslipidemia, LDL conjugated dienes and CRP levels.

Correlation Between ApoE Gene Polymorphism and LEAD in Patients with T2DM That are of Han Nationality in Northern China

To investigate the correlation between ApoE gene polymorphism and the risk of lower extremity arterial disease (LEAD) in T2DM patients of Han nationality in northern China. One hundred and fifty patients with T2DM and 150 patients with T2DM combined with LEAD were enrolled in the study and assigned to the control group and the case group, respectively. The results revealed that the number of epsilon 2 (ε2) genotype carriers in the case group was significantly lower than that in the control group (case vs control: 8.0% vs 15.4%), and the distribution of the ε2 allele frequency was similar to that of the genotype (case vs control: 4.0% vs 8.4%). A binary logistic regression analysis revealed that age, waist-to-hip ratio (WHR), and gender were risk factors for T2DM with LEAD and that the ApoE ε2 carriers was a protective factor (odds ratio [OR] 0.380; 95% confidence interval [CI] 0.162-0.892; P = .026). In male subjects, ε2 carriers were more common in the control group (case vs control:7.8% vs 24.1%), while epsilon 4 (ε4) carriers were more common in the case group (case vs control: 23.3% vs 8.6%); the distribution of frequency of ε2 and ε4 alleles was more common in the control group and the case group, respectively (case vs control: 3.9% vs 12.1%, 12.8% vs 5.2%). In male, age and WHR were risk factors for the disease, and being an ε2 carrier was a protective factor. Being an ApoE gene ε2 carrier is a protective factor for LEAD in male patients with T2DM that are of Han nationality in northern China.