Relationship between Apo E Phenotypes and Dyslipidemia in the Patients with Non-Insulin Dependent Diabetes Mellitus
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概要
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NIDDMにおける脂質代謝異常にアポE表現型がいかなる影響を及ぼすかを検討した.398名(男/女:255/143)のNIDDM患者のアポE表現型をisoelectric focusing and immunoblotting techniquesを用いて測定した.アポE表現型はE2,E3,E4の3型に分け,血中脂質,アポリポ蛋白,動脈硬化指数,Lp(a)を3群間で比較した.統計処理はKruscal-Wallis' rank testおよびMann-WhitneyのU検定と,多重ロジスティック回帰分析を行った.NIDDMにおけるアポE表現型の頻度はE2:8.8%(35/398),E3:74.4%(296/398),E4:16.8%(67/398)であった.E2,E3,E4の3群間で年齢,肥満度,血圧,空腹時血糖値に差はないが,HbA_<1c>がE3で軽度に高値であった.網膜症や腎症の合併率,心・脳血管障害の併発率,および高血圧や抗脂血剤の使用者は3群間で差を認めなかった.アポE2を有する者ではE3を有する者に比しTG,アポE濃度が高値であったが,LDL-CとLDL-C/HDL-C比およびLp(a)がいずれも有意に低値であった.またアポE2をもつものはE3をもつものに比し,高LDL-C(LDL-C≧150 mg/dl)のodds比が0.06,高Lp(a)(Lp(a)≧30mg/dl)のodds比が0.35と有意に低値であった.そしてこれらはいずれも抗脂血剤服用群において同様に認められた.一方アポE4をもつものでは,高LDL-Cと高Lp(a)の相対危険度がE3をもつものより有意に高かった(odds比は各々1.20と1.97).以上よりNIDDMにおける脂質代謝異常にアポE2は有利に働き,E4は不利に働く可能性が示唆された.Effects of apo E phenotypes on dyslipidemia in NIDDM patients were evaluated. Apo E phenotypes were determined by isoelectric focusing and immunoblotting techniques in 398 patients with NIDDM, including 255 males and 143 females. Apo E phenotypes were classified into three types: E2, E3 and E4. Blood lipid levels, apolipoproteins and Lp (a) were compared between the three groups. Statistical analyses were conducted using Mann-Whitney's U test and the multiple logistic regression analysis. The incidence of apo E phenotypes was as follows: 8.8% for E2, 74.4% for E3 and 16.8% for E4. Mean TG levels and apo E concentrations were higher in patients with apo E2 than those with apo E3, but LDL-C levels and LDL-C/HDL-C ratio were significantly lower in the former than the latter. The odds ratio for high LDL-C (LDL-C〓250mg/dl) and high Lp (a) (Lp (a)〓30mg/dl) were lower in patients with apo E2 than in those with apo E3 (0.06, 0.35 respectively). Similar patterns were observed in patients treated with lipid lowering agents. Relative risk of LDL-C and Lp (a) levels was significantly higher in patients with apo E4 than in those with E3 (odds ratio: 1.20 and 1.97, respectively). These findings suggest that apo E2 has favorable effects on dyslipidemia in NIDDM patients, while apo E4 has unfavorable effects.
- 1999-05-25
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