Apolipoprotein E gene polymorphism alters lipids before pancreas transplantation.
BACKGROUND
Pancreas transplantation (PTX) improves lipids in patients with type 1 diabetes mellitus. However, there are patients who have persistent abnormal lipids or develop new hyperlipidemia despite PTX. One factor that may influence the lipid profile is apolipoprotein E (Apo E) genotype. Apo E polymorphism, particularly E2 and E4 alleles, increases the risk of dyslipidemia. Apo E2 has also been found to increase risk of diabetic nephropathy and so may be more prevalent in PTX candidates.


METHODS
This study evaluated fasting-lipid profiles in type 1 diabetes patients who were pancreas transplant candidates to prospectively evaluate the impact of Apo E genotype on dyslipidemia before and after PTX.


RESULTS
Presence of one or more E4 alleles resulted in higher triglycerides ( =0.0446), lower HDL ( =0.0247), and a higher cholesterol-to-HDL (C/H) ratio ( =0.0405) before PTX when compared with those with E3/3 genotype. After PTX, lipids improved so there was no longer a difference in fasting lipids between patients with an E4 allele and E3/3 genotype. Presence of an E2 allele had no significant impact on fasting lipids before or after PTX.


CONCLUSIONS
Presence of an Apo E4 allele worsened HDL, triglycerides, and C/H ratio before PTX compared with those with E3/3 genotype, whereas the presence of an Apo E2 allele had no significant effect on lipids before or after PTX. Thus, Apo E4 has a larger impact than Apo E2 on fasting-lipid profile in PTX candidates, and Apo E gene polymorphism does not worsen lipid dyslipidemia after PTX, despite introduction of immunosuppressant medications known to cause dyslipidemia.
Balakrishnan
Sajeev
S
Diabetes, Endocrinology and Metabolism Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-3020, USA.
Colling
Christopher
C
Burkman
Tab
T
Erickson
Judi
J
Lyden
Elizabeth
E
Maheshwari
Hiralal
H
Mack-Shipman
Lynn
L
Lane
James
J
Larsen
Jennifer
J
D000328:Adult; D000483:Alleles; D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005838:Genotype; D006720:Homozygote; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000235:genetics; D008055:Lipids / Q000097:blood*; D008297:Male; D016035:Pancreas Transplantation; D011110:Polymorphism, Genetic / Q000502:physiology*; D014280:Triglycerides / Q000097:blood
D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol