ApoE isoforms, treatment of diabetes and the risk of coronary heart disease
2012; Volume: 3; Issue: 3 Linguagem: Inglês
10.4239/wjd.v3.i3.54
ISSN1948-9358
Autores Tópico(s)Blood Pressure and Hypertension Studies
ResumoAIM:To analyze the risk o� coronary heart disease in patients with type 2 diabetes mellitus (T2�M) receiving standard medical treatment�� METHODS: We per�ormed a retrospective chart analysis o� 269 middle-aged patients (age 45-64 years, mean age, 53��9 ± 5��5 years) with T2�M and without atherosclerotic cardiovascular events who underwent typing to determine their apolipoprotein E (apoE) iso�orms�� The apoE iso�orms were determined using isoelectric �ocusing, �ollowed by immunoblotting�� We retrospectively evaluated the charts o� the 269 patients, recorded between their first visit to the hospital (the study 's start point, between 1987 and 1992) and the occurrence of an atherosclerotic cardiovascular event (the study's endpoint) or January 2004, whichever came first.The age-adjusted mean values and the prevalences o� covariates were calculated to compare the laboratory data among the apoE phenotypes�� To investigate the association o� risk �actors with the incidence o� coronary heart disease during the �ollow-up period, monovariate and multivariate Cox regression models were used�� RESULTS: At enrollment, the mean serum low density lipoprotein (L�L) cholesterol levels were lowest (2��92 ± 0��89 mmol/L) among the subjects with apoE2 (apoE2/2 or apoE2/3) and highest (3��52 ± 0��77 mmol/L) among the subjects with apoE4 (apoE3/4 or apoE4/4)�� No significant differences in mean age or the percentage o� smokers were observed among the three groups�� Furthermore, no significant differences were observed in the systolic and diastolic blood pressures, body mass index, HbA1c level or serum triglyceride levels among the three groups�� There were 47 cases o� coronary heart disease over 3285 person-years o� �ollow-up�� An age-adjusted multivariate Cox proportional model identified diabetic retinopathy (hazard ratio, 2.38, 95% CI: 1��28-4��43, P = 0��006), a high systolic blood pressure (hazard ratio, 1.04, 95% CI: 1.02-1.06,P < 0��001)and high HbA1c values (hazard ratio, 1.19, 95% CI: 1��02-1��38, P = 0��0029), but not the L�L cholesterol value at enrollment (hazard ratio, 1.01, 95% CI: 0.97-1.05,P = 0.77) nor the specific apoE isoform, as significant predictors o� coronary heart disease�� CONCLUSION: Under standard medical treatment o� diabetes, including the control o� L�L cholesterol levels, the apoE4 iso�orm was not associated with coronary heart disease among T2�M patients��
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