Nephrol Dial Transplant (1999) 14: 2144-2149
© 1999 European Renal Association-European Dialysis and Transplant Association
Association between apolipoprotein E polymorphism and macroalbuminuria in patients with non-insulin dependent diabetes mellitus
Departments of Internal Medicine and 2 Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea and 1 Department of Internal Medicine, Ajou University College of Medicine, Suwon, Korea
Correspondence and offprint requests to: Sung-Kyu Ha MD, Department of Internal Medicine, Yongdong Severance Hospital, Yonsei University College of Medicine, Young Dong, PO Box 1217, Seoul, Korea.
Objectives. Apolipoprotein E (apo E) is known to play an important role in lipoprotein metabolism through its ability to bind to the receptors as a ligand. Three different apo E alleles (
2, 3 and 4) produce six apo E genotypes (2/2, 2/3, 2/4, 3/3, 3/4 and 4/4). The objective of this study was to investigate an association between apo E gene polymorphism and macroalbuminuria in 167 Korean patients with non-insulin dependent diabetes mellitus (NIDDM).
Methods. The patients in the macroalbuminuria group (n=74) represent those in whom 24 h urinary albumin excretion was above 300 mg. The patients in the normoalbuminuria group (n=93) represent those in whom 24 h urinary albumin excretion was below 30 mg and serum creatinine levels were less than 1.2 mg/dl. The duration of diabetes in all patients was at least 8 years.
Results. There were no significant differences in terms of age, sex, body mass index, HbA1c, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol between the two groups. In the macroalbuminuria group, the distribution of apo E genotypes revealed 2/2 2 (2.7%), 2/3 14 (18.9%), 2/4 0 (0%), 3/3 47 (63.5%), 3/4 11 (14.9%) and 4/4 0 (0%). In the normoalbuminuria group, the distribution of apo E genotypes revealed 2/2 0 (0%), 2/3 7 (7.5%), 2/4 1 (1.1%), 3/3 72 (77.4%), 3/4 12 (12.9%) and 4/4 1 (1.1%). There was no significant difference in the distribution of apo E genotypes between the two groups. However, there was a significant difference in the allele frequencies, 2 frequency was significantly higher in macroalbuminuria group compared to normoalbuminuria group (12.2% vs 4.3%, P<0.05). Also, we compared apo E carrier frequencies between the two groups. 2 carrier frequency was significantly higher in macroalbuminuria group compared to normoalbuminuria group (21.6% vs 7.6%, P<0.05). In each group, there was no significant difference in the degree of lipid abnormalities between apo 2 carrier (2/2, 2/3 genotypes), 3 carrier (3/3 genotype) and 4 carrier (3/4, 4/4 genotype).
Conclusion. Apo 2 allele and 2 carrier frequencies were significantly higher in macroalbuminuria group. These results suggest that 2 allele may be associated with the development of clinical albuminuria in Korean patients with NIDDM.
Keywords: apolipoprotein E; polymorphism; macroalbuminuria; normoalbuminuria
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