2型糖尿病患者载脂蛋白e4等位基因与颈动脉中内膜厚度的关系

目的：了解2型糖尿病（diabetes mellitus,DM)患者载脂蛋白E（apolipoprotein E,apoE)基因型与颈动脉中内膜厚度的关系。方法：选择255例无血管并发症的2型DM患者和107名健康个体，采用聚合酶链反应等位基因特异寡核苷酸探针杂交技术检测其apoE基因型。结果：2型DM组与对照组apoE基因型及等位频率差异无显著性（P＞0．05）；两组中e4/4、e4/3亚组总胆固醇、低密度脂蛋白胆固醇、脂蛋白（a)水平明显高于e3/2、e2/2亚组（P＜0．05）；两组中e4/4、e4/3亚组颈动脉中内膜厚度明显高于e3/2,e2/2亚组（P＜0．05）。不论在对照组还是在2型DM ，当调整总胆固醇、低密度脂蛋白胆固醇、甘油三酯、脂蛋白（a)、血糖、年龄、体重指数、吸烟等因素的影响后，协方差分析结果显示，颈动脉中内膜厚度在这两个基因型亚组喑差异有显著性（P＜0．05）。结论：不论在健康人还是在2型DM患者，e4等位基因与早期颈动脉粥样硬化关联。

Apolipoprotein E genotypes and carotid artery atherosclerosis in type 2 diabetes mellitus

Objective To investigate the relationhip between carotid artery intima media thickness (IMT) and apolipoprotein (Apo) E gene polymorphisms in type 2 diabetes mellitus (DM2). Methods Two hundred and fifty five DM2 patients without angiopathy and 107 healthy individuals were selected. PCR/allele specific oligonucleotide probe was used to determine their apoE genotypes. Results The prevalence distribution of apoE genotypes and alleles in DM2 patients and that in controls were similar. The TC, LDL C and Lp(a) concentrations in e4/4, e4/3 subgroups were significantly higher than those in e3/2, e2/2 subgroups ( P <0 05). The average value of IMT in e4/4 e4/3 carriers (0.89 mm) was significantly greater than that in e3/2 e2/2 carriers (0.62 mm) ( P <0 05). After adjustment for TC, LDL C, TG, Lp(a), FBG, HbA1c, age, BMI, and smoking, ANCOVA showed that the average value of carotid IMT was significantly greater in subjects with e4/4 e4/3, compared with that in subjects with e3/2 e2/2( P =0.033). Conclusion Apo e4 allele increases the risk for carotid artery atherosclerosis in the early stage of diabetic population.