Document Detail


Apolipoprotein E genotype and mortality in Southern European and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study.
MedLine Citation:
PMID:  20693183     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether cardiac and all-cause mortality are lower in Southern European (SE) patients than in Anglo-Celt (AC) patients with type 2 diabetes in an urban Australian setting, and, if so, whether ethnicity-specific differences in apolipoprotein E (APOE) genotypes are contributory. DESIGN: Longitudinal observational cohort study. METHODS: We analysed detailed data from 1057 patients from the community-based Fremantle Diabetes Study, 238 were of an SE migrant background and 819 of AC ethnicity. Cox proportional hazards modelling was used to identify independent predictors of cardiac and all-cause mortality. RESULTS: During 9.8±3.5 years of follow-up, 411 (38.9%) participants died, 161 (39.2%) from cardiac causes. Significant positive baseline independent predictors of cardiac death were age, male gender, coronary heart disease, cerebrovascular disease, peripheral arterial disease, retinopathy and peripheral neuropathy (P≤0.004), while maternal history of diabetes was protective (P=0.014). After adjusting for these variables, APOE4 carriage was predictive (hazard ratio (95% confidence interval) 1.61 (1.01-2.58); P=0.048). SE ethnicity did not add significantly to the model either as a single variable or as an interaction term with APOE4 carriage (P≥0.86). Significant independent predictors of all-cause mortality were age, male gender, smoking, coronary heart disease, cerebrovascular disease, peripheral arterial disease, retinopathy, peripheral neuropathy and microalbuminuria (P≤0.047), while overweight/obesity, lipid-lowering therapy and recent exercise were protective (P≤0.008). APOE4 carriage, SE ethnicity and their interaction did not add to the model (P≥0.32). CONCLUSIONS: SE ethnicity does not confer an independent survival advantage in community-based Australian type 2 diabetic patients, but APOE4 carriers are at higher risk of cardiac death.
Authors:
Wendy A Davis; Eunice Chin; Adelle Jee; Jen Martins; David G Bruce; John Beilby; Timothy M E Davis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-06
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  163     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  559-64     Citation Subset:  IM    
Affiliation:
School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Fremantle, Western Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Apolipoproteins E / genetics*
Australia
Diabetes Mellitus, Type 2 / ethnology,  genetics*,  mortality*
European Continental Ancestry Group
Female
Genotype
Humans
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Apolipoproteins E

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