Distribution of Apolipoprotein A1 Polymorphism (G-75A and C+83T) in Patients with Diabetic Foot Ulcers-A Parallel Group Hospital Based Observational Study

Abstract

Introduction: Diabetic Foot Ulcer (DFU), a serious complications of diabetes mellitus is a result of persistent low grade infection. The Apolipoprotein A1 (ApoA1) has an anti-inflammatory role and therefore can influence the chronic inflammation associated with the DFU. Polymorphisms of ApoA1gene have been implicated as determinants of plasma HDL-C and Apo A1 levels. However, the influence of ApoA1 polymorphism on susceptibility to DFU has not been studied. Aim: To study the distribution of ApoA1 polymorphism (G-75A and C+83T) and association between the polymorphism and the risk of DFU in patients with Type 2 Diabetes Mellitus (T2DM) so that timely detection and prevention of DFU can be done. Materials and Methods: This was a hospital based observational study on patients of DFU (n=80), diabetes mellitus without ulcers (n=80) and normal controls (n=75). ApoA1 polymorphism (G-75A and C+83T) was detected by Real Time Polymerase Chain Reaction (RTPCR) technique and plasma ApoA1 by immunoturbidimetric assay using blood collected in EDTA. Data was analysed using IBM® Statistical Package for Social Sciences (SPSS) 21.0 software. A p<0.05 was considered as statistically significant. Results: The GA and CC were the most predominant genotype in all the groups. HDL and ApoA1 were significantly lower in GG (p=0.009, p=0.03) and CT (p=0.03, p=0.002) compared to GA and CC. The APOA1-75A allele and +83C allele were associated with raised levels of HDL and ApoA1 in T2DM and DFU (p<0.05). Conclusion: The two polymorphism G-75A and C+83T were found to be equally distributed across the study populations. These polymorphisms were associated with serum levels of ApoA1 and HDL in the DFU patients.