Advertisement
Research Article| Volume 101, ISSUE 1, P9-15, June 1993

Apolipoprotein E phenotype is related to macro- and microangiopathy in patients with non-insulin-dependent diabetes mellitus

DOI:https://doi.org/10.1016/0021-9150(93)90096-D
Apolipoprotein E phenotype is related to macro- and microangiopathy in patients with non-insulin-dependent diabetes mellitus
Previous ArticleAssociation of lipoprotein subclass distribution with use of selective and non-selective beta-blocker medications in patients with coronary heart disease
Next ArticleEvidence for the presence of early vascular lesions in newborn Watanabe heritable hyperlipidemic (WHHL) rabbits
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The role of apolipoprotein E (apo E) in modulating the susceptibility of individuals with non-insulin-dependent diabetes mellitus (NIDDM) to atherosclerotic vascular disease was studied in 143 male and 128 female patients with NIDDM. The data show that the apolipoprotein phenotype E2 somehow protects from macrovascular complications in NIDDM both in men and women. E2 also tends to protect from microvascular complications. In contrast, apo E phenotypes E4/4 and E4/3 tend to increase the risk for macroangiopathy in NIDDM patients. The lower prevalence, of macroangiopathy in the subjects with E2 was associated with lower plasma total and LDL cholesterol concentrations and low plasma lipoprotein(a) levels. Overall, this study demonstrates the role of the apo E phenotype to modulate the risk for diabetic complications in patients with NIDDM. The confirmation of the association of apo E polymorphism with diabetic complications warrants, however, long-term follow-up studies.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Pyörälä K.
        • Laakso M.
        • Uusitupa M.
        Diabetes and atherosclerosis: an epidemiological view.
        Diabetes Metab. Rev. 1987; 3: 463
        • Kannel W.B.
        • McGee D.L.
        Diabetes and cardiovascular risk factors: the Framingham Study.
        Circulation. 1979; 59: 8
        • Fuller J.H.
        • Shipley M.J.
        • Rose G.
        • Jarrett R.J.
        • Keen H.
        Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall Study.
        Br. Med. J. 1983; 287: 867
        • Reunanen A.
        • Laakso M.
        • Pyörälä K.
        Cardiovascular and coronary heart disease mortality of diabetics and non diabetics: impact of risk factors (Abstract).
        J. Am. Coll. Cardiol. 1983; 1: 600
        • Rosengren A.
        • Welin L.
        • Tsipogianni A.
        • Wilhelmsen L.
        Impact of cardiovascular risk factors on coronary heart disease and mortality among middle-aged diabetic men: a general population study.
        Br. Med. J. 1989; 299: 1127
        • Stamler J.
        • Vaccaro O.
        • Wentworth D.
        • Neaton J.
        Clinical diabetes and cardiovascular risk: 10 year mortality data on the 361.662 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT) (Abstract).
        Circulation. 1990; 81: 6
        • Utermann G.
        • Kindermann I.
        • Kaffarnik H.
        • Steinmetz A.
        Apolipoprotein E phenotypes and hyperlipidemia.
        Hum. Genet. 1984; 65: 232
        • Davignon J.
        • Gregg R.E.
        • Sing C.F.
        Apolipoprotein E polymorphisms and atherosclerosis.
        Arteriosclerosis. 1988; 8: 1
        • Kuusi T.
        • Nieminen M.
        • Ehnholm C.
        • et al.
        Apoprotein E polymorphism and coronary artery disease. Increased prevalence of apolipoprotein E4 in angiographically verified coronary patients.
        Arteriosclerosis. 1989; 9: 237
        • Savolainen M.J.
        • Rantala M.
        • Kervinen K.
        • et al.
        Magnitude of dietary effects on plasma cholesterol concentration: role of sex and apolipoprotein E phenotype.
        Atherosclerosis. 1991; 86: 145
        • Rose G.
        • Blackburn H.
        • Gillum R.F.
        • Prineas R.J.
        Cardiovascular Survey Methods.
        2nd Edn. World Health Organization, Geneva1982
        • Menzel H.-J.
        • Utermann G.
        Apolipoprotein E phenotyping from serum by western blotting.
        Electrophoresis. 1986; 7: 492
        • Ehnholm C.
        • Lukka M.
        • Kuusi T.
        • Nikkilä E.
        • Utermann G.
        Apolipoprotein E polymorphism in the finnish population: gene frequencies and relation to lipoprotein concentrations.
        J. Lipid. Res. 1986; 27: 227
      14. 8th edn. Lipid Research Clinics Manual of Laboratory Operations, Lipid and Lipoprotein Analysis. 1. Department of Health, Education and Welfare (US) Publication (National Institutes of Health), 1974: 75-82
        • SAS Institute Inc.
        8th edn. SAS's user's Guide. Basics, Version 5. SAS Institute Inc, Gary, NC1985
        • Laakso M.
        • Kesäniemi Y.A.
        • Kervinen K.
        • Jauhiainen M.
        • Pyörälä K.
        Relation of coronary heart disease and apolipoprotein E phenotype in patients with noninsulin-dependent diabetes.
        Br. Med. J. 1991; 303: 1159
        • Winocour P.H.
        • Tetlow L.
        • Durrington P.N.
        • Ishola M.
        • Hillier V.
        • Anderson D.C.
        Apolipoprotein E polymorphism and lipoproteins in insulin-treated diabetes mellitus.
        Atherosclerosis. 1989; 75: 167
        • Imari Y.
        • Koga S.
        • Ibayashi H.
        Phenotypes of apolipoprotein E and abnormalities in lipid metabolisms in patients with diabetes mellitus.
        Metabolism. 1988; 37: 1134
        • Eto M.
        • Watanabe K.
        • Iwashima Y.
        • Morikawa A.
        • Oshima E.
        • Sekiguchi M.
        • Ishii K.
        Apolipoprotein E polymorphism and hyperlipidemia in Type II diabetics.
        Diabetes. 1986; 35: 1374
        • Cumming A.M.
        • Robertson F.
        Polymorphism at the apo E locus in relation to risk of coronary artery disease.
        Clin. Genet. 1984; 25: 310
        • Menzel H.-J.
        • Kladetzky R.-G.
        • Assmann G.
        Apolipoprotein E polymorphism and coronary artery disease.
        Arteriosclerosis. 1983; 3: 310
        • Lenzen H.J.
        • Assman G.
        • Buchwalsky R.
        • Schulte H.
        Association of apolipoprotein E polymorphism, low density lipoprotein cholesterol and coronary artery disease.
        Clin. Chem. 1986; 32: 778
        • Assmann G.
        • Schmitz G.
        • Menzel H.J.
        • Schulte H.
        Apolipoprotein E polymorphism and hyperlipidemia.
        Clin. Chem. 1984; 30: 641
        • Leren T.P.
        • Borresen A.L.
        • Hjermann I.
        • Leren P.
        • Berg K.
        Increased frequency of the apolipoprotein E-4 isoform in male subjects with multifactorial hypercholesterolemia.
        Clin. Genet. 1985; 27: 458
        • Sing C.F.
        • Davignon J.
        Role of apolipoprotein E polymorphism in determining normal plasma lipid and lipoprotein variation.
        Am. J. Hum. Genet. 1985; 37: 268
        • Berg K.
        A new serum type system in man - the Lp system.
        Acta Pathol. Microbiol. Scand. 1963; 59: 369
        • Utermann G.
        The mysteries of lipoprotein (a).
        Science (Wash. DC). 1989; 246: 904
        • Lawn R.M.
        The structure and evolution of apolipoprotein(a) In: Scanu, A.M. (moderator), Lipoprotein(a) and Atherosclerosis.
        Ann. Intern. Med. 1991; 115: 209
        • De Knijff P.
        • Kaptein A.
        • Boomsma D.
        • Princen H.M.G.
        • Frants R.R.
        • Havekes L.M.
        Apolipoprotein E polymorphism affects plasma levels of lipoprotein (a).
        Atherosclerosis. 1991; 90: 169
        • Jenkins A.J.
        • Steele J.S.
        • Janus E.D.
        • Best J.D.
        Increased plasma apolipoprotein (a) levels in IDDM patients with microalbuminuria.
        Diabetes. 1991; 40: 787
        • Kapelrud H.
        • Bangstad H.J.
        • Dahl-Jorgensen K.
        • Berg K.
        • Hanssen K.F.
        Serum Lp(a) lipoprotein concentrations in insulin dependent diabetic patients with microalbuminuria.
        Br. Med. J. 1991; 303: 675
        • Haffner S.M.
        • Tuttle K.R.
        • Rainwater D.L.
        Lack of change of lipoprotein (a) concentration with improved glycemic control in subjects with type lI diabetes.
        Metabolism. 1992; 41: 116
        • Ramirez L.C.
        • Arauz-Pacheco C.
        • Lackner C.
        • Albright G.
        • Adams B.V.
        • Raskin P.
        Lipoprotein (a) levels in diabetes mellitus: Relationship to metabolic control.
        Ann. Int. Med. 1992; 117: 42
        • Mahley R.W.
        Apolipoprotein E: Cholesterol transport protein with expanding role in cell biology.
        Science. 1988; 240: 622
        • Hui D.Y.
        • Harmony J.A.
        • Innerarity T.L.
        • Mahley R.
        Immunoregulatory plasma lipoproteins. Role of apoprotein E and apoprotein B.
        J. Biol. Chem. 1980; 255: 11775
        • Pepe M.G.
        • Curtiss L.K.
        Apolipoprotein E is a biologically active constituent of the normal immunoregulatory lipoprotein, LDL-In.
        J. Immunol. 1986; 136: 3716
        • Deckert T.
        • Feldt-Rasmussen B.
        • Borch-Johnsen K.
        • Jensen T.
        • Kofoed-Enevoldsen A.
        Albuminuria reflects widespread vascular damage. The steno hypothesis.
        Diabetologia. 1989; 32: 219

      Article info

      Publication history

      Accepted: February 9, 1993
      Received in revised form: February 8, 1993
      Received: October 8, 1992

      Identification

      DOI: https://doi.org/10.1016/0021-9150(93)90096-D

      Copyright

      © 1993 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX