Abstract
BackgroundApolipoprotein E (APOE) gene mediates lipoprotein clearance and is one of the most studied candidate genes for type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD). This study was performed to determine the association between APOE polymorphisms and T2DM with and without CAD, and its effect on plasma lipid levels in a Chinese population.MethodsA total of 1,414 subjects involving 869 patients and 545 health individuals were recruited. These patients were categorized into three distinct groups: 264 in T2DM group, 401 in CAD group, and 204 in T2DM+CAD group. Logistic regression analysis was used to obtain odds ratio (OR) and 95% confidence interval (CI) in predicting the risk probability of APOE. Besides, a meta-analysis was preformed to integrate an evaluation index to evaluate their associations.ResultsGenotype frequency ratio of genotype ϵ3/4 and allele ϵ4 among the CAD patients with or without T2DM was obviously increased. Compared with ϵ3/3 genotype, the ϵ3/4 genotype had a significant increased risk of CAD (adjusted OR = 1.90, 95% CI = 1.30–2.77) and T2DM+CAD (adjusted OR = 1.95, 95% CI = 1.24–3.08). In the meta-analysis, four studies were included and provided a strong evidence for the APOE ϵ4 mutation elevating the risk of CAD in patients with T2DM (ϵ3/ϵ4+ϵ4/ϵ4 vs. ϵ3/ϵ3, OR = 1.51, 95% CI = 1.13–2.02). In the T2DM group, the plasma levels of low-density lipoprotein cholesterol (LDL-C) showed significant difference among the three APOE isoforms. The high-density lipoprotein cholesterol (HDL-C) levels of CAD patients with ϵ4-bearing genotypes were lower than those with ϵ3/3 genotype.ConclusionsOur results indicate that APOE gene polymorphisms are related to CAD with or without T2DM and have influence on lipid profiles in both T2DM and CAD patients.
Highlights
Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disease characterized by high levels of sugar in the blood and is prevalent throughout the world
The data from normal controls were used as a reference to compare with the data obtained from three observation groups consisted of patients with T2DM, coronary artery disease (CAD), and T2DM+CAD
When combined with the analysis the polymorphism of Apolipoprotein E (APOE) and blood lipid levels, these results provided new understanding on the correlation between APOE gene and T2DM patients with CAD
Summary
Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disease characterized by high levels of sugar in the blood and is prevalent throughout the world. T2DM frequently coexists with various complications such as hypertension and dyslipidemia and is known as a major independent risk factor for coronary artery disease (CAD) [2]. Patients with T2DM have two- to fourfold greater risk of developing CAD compared to individuals without diabetes [3]. The development of CAD in the setting of T2DM due to a complex combination of various risk factors plays important role in the beginning and the evolution of atherosclerosis [4]. Apolipoprotein E (APOE) gene mediates lipoprotein clearance and is one of the most studied candidate genes for type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD). This study was performed to determine the association between APOE polymorphisms and T2DM with and without CAD, and its effect on plasma lipid levels in a Chinese population
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