The apolipoprotein E (APOE) gene and the risk of diabetic nephropathy (DN): a meta-analysis in East Asian populations

Background: Several studies have examined the association between DN and the APOE gene, but the results have been inconsistent. Objective: Determine whether APOE is a risk factor for DN by a meta-analysis. Methods: A meta-analysis was performed using all findings of 16 similar case-control studies in East Asian to evaluate the effect of APOE as a risk factor for DN. Several electronic databases were searched for relevant articles up to 2009. After data collection, a meta-analysis was used to assess heterogeneity, combine results and evaluate variations by using software STATA SE 9.0. Publication bias was examined by the Egger’s linear regression test and fail-safe number. Results: The meta-analysis showed that the ε2 allele almost doubled the risk of DN in East Asians (pooled ORs [95% CI]: 1.85 [1.49-2.29]). In contrast, studies relating the ε4 allele to DN risk were very heterogeneous and the pooled ORs were 1.05 [95% CI: 0.72-1.52]. In the subgroup meta-analysis, ε4 was substantially related to an increased risk for DN in studies conducted in China (pooled ORs [95% CI]: 1.51 [1.11-2.06]), which was different from previous results. However, the higher risk of DN associated with ε4 was not found in Japanese or Korean populations (pooled ORs [95% CI]: 0.46 [0.27-0.80] and 0.58 [0.09-3.55], respectively). Conclusion: The ε2 allele conferred a higher risk of DN in East Asians, and no significant result was obtained with the ε4 allele.