APOLIPOPROTEIN E (APOE) GENE POLYMORPHISMS AND THEIR ASSOCIATION WITH CARDIOVASCULAR DISEASE (CVD) IN TYPE 2 DIABETES MELLITUS (T2DM)

Received 2023-06-26; Accepted 2023-09-06; Published 2024-01-11

Abstract

Apolipoprotein E (ApoE) is well known for its crucial role in lipid metabolism and is associated with an increased risk of cardiovascular disease (CVD) among subjects with type 2 diabetes mellitus (T2DM). Various apolipoprotein gene families have been determined, including APO (A-I), APO (A-II), APO (A-IV), APO (C-1), APO (C-II), APO (C-III), and APOE. A total of 3,597 nucleotides are encoded by the APOE gene, with four exons and three introns, constituting a polypeptide with 299 amino acids. The current study embarks on linking APOE gene polymorphisms with CVD among patients diagnosed with T2DM. This cross-sectional study involved 101 subjects with specific inclusion and exclusion criteria. The participants were separated into two groups, T2DM (n = 59) and T2DM with CVD (n = 42). Comparative analyses of clinical and biochemical characteristics were performed using student’s t-test and Pearson’s chi-square test (x²). Univariate and multivariate analyses were applied to establish the relationship between APOE gene polymorphisms with ischemic heart disease. The ε3/ε3 genotype was the most prevalent among both groups. The ε3/ε3 genotype (AOR= 0.052; 95% CI = 0.003-0.792; p = 0.033), ε3 allele (AOR = 34.83; 95% CI = 1.118-1085.134; p = 0.043), systolic blood pressure (SBP) (AOR = 1.046; 95% CI = 1.002-1.091; p = 0.042), and HbA1c (AOR = 2.286; 95% CI = 1.577-3.314; p < 0.001) were significantly associated with CVD. The ε3/ε3 genotype was also significantly associated with the lipid parameter, low density lipoprotein cholesterol (LDLc) (p = 0.011). Most T2DM patients presented with ε3 allele which may affect lipid profiles and the risk of CVD disease. This highlights the need to establish APOE as a likely predictive gene for CVD disease in T2DM subjects.