A Study of Apolipoprotein E4, Coronary Risk Factors and Peripheral Arterial Disease among Elderly with Diabetes Mellitus Thesis

Abstract

The progression and development of DM and CAD is the consequence of multifactorial parameters, as obesity, smoking, oxidative stress, defect in pancreatic β-cells, alcohol consumption, exercise, hypertension and genetic factors. The presence of PAD is an indicator of widespread atherosclerosis in other vascular territories such as the coronary, carotid, and cerebrovascular arteries. PAD prevalence increases progressively with age and is associated with significant CV morbidity and mortality. ApoE gene is one of the most widely studied candidate genes for CAD or any other form of CVD and/or DM. A significant relationship of apo E polymorphism and CAD has been observed in several ethnic groupssuggesting that carriers of APOE-ɛ4 allele have a distinct plasma lipids profile and carrier of this allele with low levels of HDL-C and with high levels of LDL-C may be susceptible to CAD and MI especially in diabetic patients. The objectives of the present study was to assess the genetic frequency of the apolipoprotein E4 and the prevalence of PAD among a target group of elderly diabetics with and without atherosclerotic complications, with respect to the presence of established CVD and/or major coronary risk factors, compared to non-diabetic elderly controls.