title: Apolipoprotein E polymorphism and the progression of diabetic nephropathy in type 2 diabetes.
abstract: OBJECTIVE
  Three different apo E alleles (E2, E3 and E4) produce apo E isoproteins, which regulate the metabolism of lipoproteins. This study investigated the apo E polymorphisms as a prognostic factor for the development of diabetic nephropathy (DN).
  
  
  METHODS
  A total of 525 type 2 diabetic patients were enrolled to participate in this prospective observational study. Apo E gene polymorphisms were analyzed by polymerase chain reaction. The progression of DN was defined as a shift to a higher stage of DN or a doubling of the baseline serum creatinine level by the end of the study.
  
  
  RESULTS
  The mean follow-up period was 42.4 months. The patients whose DN progressed had significantly higher urine albumin/creatinine ratios and fewer used diuretics than those in whom DN did not progress. In the Cox regression analysis, the apo E4 carriers were found to be at greater risk of progression of DN than non-apo E4 carriers (p = 0.007, hazard ratio 2.252). After adjusting for confounding factors, apo E4 carriers remained at increased risk of progression to more severe DN (p = 0.002, hazard ratio 2.820).
  
  
  CONCLUSIONS
  Our study suggests the apo E4 carrier might serve as a predictor of DN progression in Taiwan.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC.
authors.forename: Kai-Jen
authors.initials: KJ
authors.lastname: Tien
authors.forename: Shih-Te
authors.initials: ST
authors.lastname: Tu
authors.forename: Chien-Wen
authors.initials: CW
authors.lastname: Chou
authors.forename: Chwen-Yi
authors.initials: CY
authors.lastname: Yang
authors.forename: Jeng-Yueh
authors.initials: JY
authors.lastname: Hsiao
authors.forename: Shyi-Jang
authors.initials: SJ
authors.lastname: Shin
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Hsieh
mesh_terms: D001057:Apolipoproteins E / Q000097:blood / Q000235:genetics*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000235:genetics; D003928:Diabetic Nephropathies / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011110:Polymorphism, Genetic; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D001057:Apolipoproteins E