Apolipoprotein E gene polymorphism: effects on plasma lipids and risk of type 2 diabetes and coronary artery disease

Cardiovascular Diabetology, 04/25/2012

These results indicate that epsilon4 allele has influence on lipid profiles and is associated with the development of both type 2 diabetes mellitus (T2DM) with and without coronary artery disease (CAD), and furthermore, it increased the risk among the subjects with obesity and/or smoking, the conditions associated with high oxidative stress.


  • The case–control study was carried out on a total of 451 samples including 149 normal control subjects, 155 subjects with T2DM, and 147 subjects with T2DM complicated with CAD.
  • The apoE gene polymorphism was tested by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP).
  • Univariable and multivariable logistic regression analyses were used to identify the possible risks of T2DM and CAD.


  • A significantly increased frequency of E3/E4 genotype was observed only in T2DM with CAD group (p = 0.0004), whereas the epsilon4 allele was significantly higher in both T2DM (p = 0.047) and T2DM with CAD (p = 0.009) as compared with controls.
  • E3/E4 genotype was also the independent risk in developing CAD after adjusting with established risk factors with adjusted odds ratio (OR) 2.52 (95%CI 1.28–4.97, p = 0.008).
  • The independent predictor of individuals carrying epsilon4 allele still remained significantly associated with both CAD (adjusted OR 2.32, 95%CI 1.17–4.61, p = 0.016) and T2DM (adjusted OR 2.04, 95%CI 1.07–3.86, p = 0.029).
  • After simultaneously examining the joint association of E3/E4 genotype combined with either obesity or smoking the risk increased to approximately 5–fold in T2DM (adjusted OR 4.93, 95%CI 1.74–13.98, p = 0.003) and 10–fold in CAD (adjusted OR 10.48, 95%CI 3.56–30.79, p < 0.0001).
  • The association between apoE genotypes on plasma lipid levels was compared between E3/E3 as a reference and E4–bearing genotypes.
  • E4–bearing genotypes showed lower HDL–C and higher VLDL–C and TG, whereas other values of plasma lipid concentrations showed no significant difference.

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