Estimation of Dysbetalipoproteinemia Incidence in Iraqi Patients with Diabetes Mellitus and Cardiovascular Disease

Abstract

Background: The main obvious manifestations in dysbetalipiproteinemia (DBL) are Apo-B, non-high-density lipoprotein cholesterol (non-HDLc) and Apo-E gene polymorphism, with a remarkable controversy in the results among different workers. The aim of the study was to find a suitable variable or formula for diagnosis of familial or secondary DBL in a sample of Iraqi patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Material and methods: The study involved 50 patients with T2DM (mean age 46.48 ±9.3 years), 26 patients with CVD (mean age: 43.15±7.34 years) and 73 apparently healthy normal control individuals (mean age: 34.51±11.47 years) with almost equal male/female ratio. Serum lipids (TC, TG, HDL-c, LDL-c, VLDL-c, Remnant like particles RLP, Apo-B, and Apo-E) were estimated in patients and controls. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of non-HDL-c and non-HDL-c /Apo-B in the context of discrimination between patients with- and without DBL. Results: All measured serum lipids, were higher in patients than controls, except HDL-c. Using Sniderman algorithm, 13 patients (18.06%) among T2DM and CVD were considered to have DBL, while none of control group had this disorder. Conclusion Based on Sniderman algorithm, ROC revealed a better specificity and sensitivity for non- HDLc to diagnose DBL, Keywords: dysbetalipoproteinemia, Apo-B, Non- HDL cholesterol, Sniderman algorithm, Cardiovascular disease, Diabetes mellitus.

Apoprotein-E gene polymorphism in an Iraqi population with type 2 diabetes and cardiovascular disease

“…ApoE gene is located on chromosome 19 at position q13.2a. The ApoE glycoprotein consists of 299 amino acids, and has three alleles ε2, ε3, and ε4, differing from one another by one amino acid substitution (5,6). The glycoprotein is known to regulate physiological activities such as lipid metabolism, cognitive function, and immune regulation (5).…”

“…The glycoprotein is known to regulate physiological activities such as lipid metabolism, cognitive function, and immune regulation (5). The ApoE alleles ε2, and ε4 together with other allelic genes are considered risk factors in dysbeta-lipoproteinemia (DBL) susceptibility which is associated with both T2DM and CVD (5,6).…”

“…ApoE3 is responsible for the conversion of very lowdensity lipoprotein (VLDL) and its remnants to LDL in the liver, whereas ApoE2 has been shown to inhibit this process, resulting in the appearance of high cholesterolcontaining remnants in the blood, which can lead to premature coronary heart disease (5). Homozygous carriers of ApoE2 (Arg158→Cys158) are reported to develop hyperlipidemia (6), while few reports showed a strong association to the ε4 allele with the risk of CVD (9), and a cause of increased risk especially in diabetic patients (10).…”