Tavintharan S, Lim S C, Chan Y H, Sum C F
Department of Medicine, Alexandra Hospital, Singapore.
Diabetes Obes Metab. 2007 Jan;9(1):81-6. doi: 10.1111/j.1463-1326.2006.00577.x.
To evaluate the effect of apolipoprotein E (apoE) genotype on baseline lipid levels and the response to hydroxy-methyl glutaryl coenzyme A reductase inhibitors (statins) therapy in Chinese patients with type 2 diabetes mellitus (DM).
We consecutively recruited Chinese patients with type 2 DM requiring lipid-lowering therapy according to current guidelines. Patients were started on either simvastatin 10 mg daily or given an equivalent dose of lovastatin 20 mg. After 12 weeks of statin therapy, patients had fasting lipid profiles repeated. ApoE genotyping was performed by restriction fragment length polymorphism (RFLP).
Ninety-six patients were studied. The epsilon3/epsilon3 genotype was in 62.5%, epsilon2/epsilon3 and epsilon3/epsilon4, 16.7 and 20.8%, respectively. After adjusting for confounding variables, baseline total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels were significantly higher in those with epsilon3/epsilon4 compared with epsilon2/epsilon3 genotype (6.7 vs. 5.5 mm for TC, 4.5 vs. 3.6 mm for LDL-C; p = 0.015 and p = 0.025, respectively). With statin therapy, epsilon3/epsilon4 patients had significantly greater LDL-C lowering compared with epsilon2/epsilon3 patients (48 vs. 27.7%; p = 0.04). There was no gender difference in baseline lipid parameters or response to statin therapy.
ApoE genotype accounts for interindividual variability of baseline cholesterol levels, and response to statin therapy in Chinese patients with type 2 DM.
评估载脂蛋白E（apoE）基因型对中国2型糖尿病（DM）患者基线血脂水平及对羟甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）治疗反应的影响。
我们根据现行指南连续招募需要降脂治疗的中国2型糖尿病患者。患者开始每日服用10 mg辛伐他汀或给予等效剂量的20 mg洛伐他汀。他汀类药物治疗12周后，重复检测患者的空腹血脂谱。采用限制性片段长度多态性（RFLP）进行apoE基因分型。
共研究了96例患者。ε3/ε3基因型占62.5%，ε2/ε3和ε3/ε4基因型分别占16.7%和20.8%。校正混杂变量后，与ε2/ε3基因型相比，ε3/ε4基因型患者的基线总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平显著更高（TC分别为6.7 vs. 5.5 mmol/L，LDL-C分别为4.5 vs. 3.6 mmol/L；p = 0.015和p = 0.025）。在他汀类药物治疗中，ε3/ε4基因型患者的LDL-C降低幅度显著大于ε2/ε3基因型患者（48% vs. 27.7%；p = 0.04）。基线血脂参数或对他汀类药物治疗的反应无性别差异。
apoE基因型可解释中国2型糖尿病患者基线胆固醇水平的个体差异以及对他汀类药物治疗的反应。
