Apolipoprotein E Genetic Polymorphisms and the Development of Nephropathy in Type 2 Diabetes
Bancha Satirapoj MD*, Ouppatham Supasyndh MD*, Rattanawan Dispan MS**, Dollapas Punpanich MS**, Siriwan Tribanyatkul MS**, Panbuppa Choovichian MD*
Affiliation : * Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ** Research Unit, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Background : Apolipoprotein E (ApoE) polymorphisms have been proposed as the risk factor for the development of diabetic
nephropathy (DN). A number of studies have investigated the association between the ApoE isoforms and DN. However,
the findings remain inconclusive.
Objective : To determine the association between the ApoE polymorphisms and DN.
Material and Method: Two hundred thirty patients with type 2 diabetes were divided into two groups, patients with clinically
diagnosed DN and normoalbuminuric patients. ApoE genotypes were determined by RT-PCR analysis. Student’s t-test,
ANOVA test, Chi-square test, odds ratio, and logistic regression was performed.
Results : The frequency of ApoE4 genotype was significantly lower in DN patients (8.7%) than in normoalbuminuric patients
(21.7%). Logistical regression analysis showed that subjects with ApoE4 genotype (adjusted OR = 0.43; 95% CI: 0.19-0.99)
were less likely to have DN than subjects with ApoE3 genotype. Furthermore, when analyzed only in patients with overt
DN vs. patients with normoalbuminuria, the frequency of e4 allele was decreased in overt DN (2.8% vs. 21.7%, adjusted
OR = 0.13; 95% CI: 0.03-0.57) and the frequency of e2 allele was increased (25.4% vs. 13.0%, adjusted OR = 2.34;
95% CI: 1.02- 5.38).
Conclusion : ApoE4 genotype is associated with protection from type 2 DN, and subjects with e2 allele have increased risk
of developing type 2 overt DN.
Keywords : Diabetic nephropathy, Type 2 diabetes, Apolipoprotein E Polymorphisms, ApoE
