Association of rs429358 and rs7412 polymorphism in apolipoprotein E gene with the severity of neuropathy among type 2 diabetes patients.

BACKGROUND: Genetic factors might influence the pathophysiology of diabetic peripheral neuropathy (DPN) which leads to the variability in its severity. The present study aimed to find the association of apolipoprotein E (APOE) gene polymorphism with the severe DPN in patients with type 2 diabetes mellitus (T2DM). METHODS: Type 2 diabetes patients were divided into group I (no neuropathy) and group II (mild/moderate/severe neuropathy). Further, the subgroup analysis of group II was done to determine the difference in symptomatic severity. The nerve conduction study was done to measure various parameters such as latency, amplitude, and velocity of both motor and sensory nerves in the upper and lower limbs. The APOE gene polymorphism was analysed by using a TaqMan allelic discrimination assay using real-time polymerase chain reaction (PCR). RESULTS: There was not a significant difference found in the demographical parameters in the variants of APOE gene. However, there was a significant difference found in the LDL level in the patients carrying ε4 allele as compared to non-carrier. Furthermore, the nerve function parameters and the Utah Early Neuropathy Scale (UENS) score was significantly high in patients carrying with ε4 allele. The patients with mild/moderate neuropathy have 1.4 times higher odds of presence of ε4 allele as compared to patients with no neuropathy. The patients with severe neuropathy have three times higher odds of presence of ε4 allele as compared to patients with no neuropathy. CONCLUSION: In conclusion, the present study showed that ε4 allele significantly associated with the severity of peripheral neuropathy in patients with type 2 diabetes in the Indian population.