Apo 4 allele increases the risk for exercise-induced silent myocardial ischemia in non-insulin-dependent diabetes mellitus

Objective: To examine whether the Apo 4 allele is associated with an increased risk for exercise-induced silent myocardial ischemia (SI) in non-insulin-dependent diabetes mellitus (NIDDM). Methods: One-hundred and sixty-six NIDDM patients with normal rest electrocardiography were selected randomly. Of them, 77 cases were SI, and 89 without SI. Seventy-two healthy individuals without SI were also selected as controls. Polymerase chain reaction/ASO probes was used to determined their mouthwash DNA apolipoprotein E genotypes. Results: (1) In the NIDDM with SI group, the prevalence of 4/3 was 31.2%, which was significantly higher than 9.7% in control and 7.9% in NIDDM without SI (P<0.005). 3/3 was 55.8%, which was significantly lower than 73.6% in control and NIDDM without SI (P<0.05). (2) In the NIDDM without SI group, 4/3 was 7.9%, which was significantly lower than 18.7% in NIDDM (P<0.05). In addition, the 4 allele prevalence was 19.5%, which was significantly higher than 5.6% in NIDDM without SI (P<0.005), and 9% in control, 12% in NIDDM (P<0.05). (3) In the 4/3 4/4 group for NIDDM, the prevalence of SI was 77%, which was significantly higher than 39% in the 3/3 group and 29% in the 2/2 3/2 group (P<0.005). Conclusion: The 4 allele increases the risk for SI in NIDDM.