J Med Assoc Thai 2013; 96 (9):1119

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Apolipoprotein E Genetic Polymorphisms and the Development of Nephropathy in Type 2 Diabetes
Satirapoj B Mail, Supasyndh O , Dispan R , Punpanich D , Tribanyatkul S , Choovichian P

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


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