El-Lebedy Dalia, Raslan Hala M, Mohammed Asmaa M
Medical Research Division, Department of Clinical and Chemical Pathology, National Research Centre, Al-Bohouth Street, Cairo, 12311, Egypt.
Medical Research Division, Department of Internal Medicine, National Research Centre, Cairo, Egypt.
Cardiovasc Diabetol. 2016 Jan 22;15:12. doi: 10.1186/s12933-016-0329-1.
Lipoprotein-related mechanisms have been associated with damage to the cardiovascular system in diabetic patients. Apolipoprotein E gene which affects the clearance of lipoproteins and consequently the lipid profile in our body is one of the most studied candidate genes and recently has been reported to be associated with T2DM and CAD. In this work, we studied the association of apoE gene polymorphism with T2DM and CVD and its effect on plasma lipids profile.
Our study was conducted on 284 subjects categorized into 100 patients with T2DM, 100 patients with T2DM complicated with CVD and 84 normal control subjects. ApoE gene polymorphism was genotyped by real-time PCR using TaqMan(®) SNP Genotyping Assay.
ApoE E3/E3 genotype was the most common in our subjects. The frequencies of E3/E4 genotype and ε4 allele were increased in both T2DM patients and CVD patients as compared with controls, but were significant only in CVD patients (p = 0.004 and 0.007, respectively). Diabetic patients who carried E3/E4 genotype were at 2.4-fold increased risk to develop CVD (95 % CI 1.14-5.19, P = 0.02) and the ε4 allele associated with 2.23-fold higher CVD risk (95 % CI 1.09-4.59, P = 0.02). After adjustment for other established risk factors, E3/E4 genotype was an independent risk factor for CVD (OR = 2.3, p = 0.009) but not for T2DM (OR = 1.7, p = 0.28), while ε4 allele was an independent risk factor for both T2DM (OR = 2.2, p = 0.04) and CVD (OR = 3.0, p = 0.018) with 5.9-fold increased risk to develop CVD in T2DM patients (p = 0.019). E3/E4 genotype associated with significantly higher levels of TC and non HDL-C in all groups and with significantly higher levels of LDL-C in both T2DM and CVD patients.
ApoE gene polymorphisms associate with CVD and affect the lipid profile. The ε4 allele is an independent risk factor for both T2DM and CVD. Further genetic studies to add information beyond the traditional cardiovascular risk factors in T2DM and to identify risk genotypes will help in early prediction and identification of at risk patients.
脂蛋白相关机制与糖尿病患者心血管系统损伤有关。载脂蛋白E基因影响脂蛋白的清除，进而影响我们体内的血脂谱，是研究最多的候选基因之一，最近有报道称其与2型糖尿病和冠心病有关。在本研究中，我们研究了载脂蛋白E基因多态性与2型糖尿病和心血管疾病的关联及其对血脂谱的影响。
我们对284名受试者进行了研究，分为100例2型糖尿病患者、100例合并心血管疾病的2型糖尿病患者和84名正常对照受试者。采用TaqMan(®)SNP基因分型检测法通过实时聚合酶链反应对载脂蛋白E基因多态性进行基因分型。
载脂蛋白E E3/E3基因型在我们的受试者中最为常见。与对照组相比，2型糖尿病患者和心血管疾病患者中E3/E4基因型和ε4等位基因的频率均有所增加，但仅在心血管疾病患者中具有统计学意义（分别为p = 0.004和0.007）。携带E3/E4基因型的糖尿病患者发生心血管疾病的风险增加2.4倍（95%可信区间1.14-5.19，P = 0.02）,ε4等位基因与心血管疾病风险增加2.23倍相关（95%可信区间1.09-4.59，P = 0.02）。在对其他已确定的危险因素进行调整后，E3/E4基因型是心血管疾病的独立危险因素（比值比=2.3，p = 0.009），但不是2型糖尿病的独立危险因素（比值比=1.7，p = 0.28），而ε4等位基因是2型糖尿病（比值比=2.2，p = 0.04）和心血管疾病（比值比=3.0，p = 0.018）的独立危险因素，2型糖尿病患者发生心血管疾病的风险增加5.9倍（p = 0.019）。E3/E4基因型与所有组中显著更高的总胆固醇和非高密度脂蛋白胆固醇水平相关，与2型糖尿病和心血管疾病患者中显著更高的低密度脂蛋白胆固醇水平相关。
载脂蛋白E基因多态性与心血管疾病相关并影响血脂谱。ε4等位基因是2型糖尿病和心血管疾病的独立危险因素。进一步的遗传学研究以补充2型糖尿病中传统心血管危险因素以外的信息并识别风险基因型，将有助于早期预测和识别高危患者。
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