Apolipoprotein E gene polymorphism, hypercholesterolemia and glomerular filtration rate in type 2 diabetic subjects: A 9-year follow-up study

Abstract

ApoE allele epsilon4 may speed up the rate of decline of the GFR in patients with progressive diabetic renal disease.

Apolipoprotein E Polymorphism and the Progression of Diabetic Nephropathy in Type 2 Diabetes

“…Our results confirm a follow-up Finnish study of 84 type 2 diabetic patients in which E4 carriers were found to be at increased risk of declining GFR [5]. Joss et al [17], also using a decline rate of GFR as outcome measure in a 2-year prospective study of 90 type 2 diabetic patients, also reported that patients with apo E3/E4 genotype had faster rates of renal failure.…”

“…Hence, we classified the progression of DN via albuminuria status and by doubling the serum Cr level to comprehensively follow up the course of DN. The definition of progression of DN in our study is different from previous reports which have only used a change in albuminuria or Cr in their definitions, but not both [5,16,22,23]. Without taking both into consideration, it is easy to lose the integrated view of progression of DN.…”

“…Albuminuria, elevated blood pressure (BP), and metabolic abnormalities explain only 30–50% of the variation in the progression of DN [3,4]. Familial clustering of diabetes and ethnic variation of DN suggest that hereditary factors also play an important role [5,6]. …”

ApoE phenotype is associated with inflammatory markers in middle-aged subjects

“…ApoE phenotype has been associated with renal function in earlier studies but the results have remained controversial. Some of these studies have suggested that apoE2 [21,22] is associated with increased serum creatinine levels whereas others have shown that the apoE4 allele is a risk factor for the progression of renal failure [23]. Differences in study design and patient selection may explain these discrepancies.…”

Biomedical Vignette

“…Lehtinen et al [19] described the findings of a prospective study investigating a possible correlation between apolipoprotein E (ApoE) gene polymorphism and progression of renal failure mediated by hypercholesterolemia in type 2 diabetic patients, as measured by the glomerular filtration rate. Previous reports presented cross-sectional case-control studies and yielded inconsistent results [3,5,14,23].…”