Abstract
Some studies have shown the correlation between E4 type of Apolipoprotein E gene and diabetic neuropathy, however, there are contradicting results in recent studies. The aim of this meta-analysis was to investigate the association between APOE4 gene and diabetic neuropathy. Database of Pubmed, Wuhan University Library, and Google were searched. A total of 56 studies were screened and 5 studies were selected for quantitative meta- analysis. This meta-analysis was performed to assess heterogeneity and combine results by using software RevMan 5.2. Strength and relationship were calculated as the odds ratio (OR) with a confidence interval (CL) of 95% using generic inverse variance data. Sensitivity analysis and Publication Bias analysis was conducted. A total of 5 studies were included for quantitative analysis with total of 914 patients (498 diabetic patients with neuropathy as case and 416 diabetic patients without neuropathy as controls). The result of our study indicated that APOE4 carriers were likely to have high risk of diabetic neuropathy. (E4 vs. others; pooled OR with 95% confidence interval 1.80 (1.28, 2.53), p< 0.05 (p =0.0007)). In conclusion, this meta-analysis suggests that there is significant association between APOE4 gene and occurrence of diabetic peripheral neuropathy. However, further studies are needed for more detailed analysis.
Highlights
There is a rising worldwide prevalence of diabetes, which is one of the most challenging health problems in the 21st century
The information related to first author, year of publication, country, sample size of case (DPN+) and control (DPN-) for each APOE genotype with allele carriers are presented in table 1
APOE is not an independent risk factor for diabetic foot. These studies show that the results are still inconclusive and further studies are needed to evaluate the APOE gene susceptibility in association with diabetic neuropathy
Summary
There is a rising worldwide prevalence of diabetes, which is one of the most challenging health problems in the 21st century. The most common neuropathies are diabetic peripheral neuropathy (DPN) and cardiovascular autonomic neuropathy (CAN) [6]. These neuropathies in patients having diabetes are diverse in character of their symptoms, neurological involvement, risk factors, underlying mechanisms and pathology. Association of APOE gene with cardiovascular disease and neurological disorders of the central and peripheral nervous system mainly Alzheimer’s disease has been widely accepted [7]. Studies have shown positive association of APOE gene with diabetic nephropathy [8]. We performed this meta-analysis to provide a reliable evaluation of the association between APOE4 carriers and diabetic neuropathy
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