Associations Between Apolipoprotein E Gene Polymorphisms And Cardiovascular Complications Of End-stage Renal Disease Patients On Maintenance Hemodialysis

Objective: It is reported that End-stage renal disease(ESRD)patients have a high risk rate of mortality.However,a recent study reported that despite dialysis treatment,ESRD patients still had a high rate of death with cardiovascular disease as the main cause.It has been shown that Apo E gene polymorphisms were involved in a variety of diseases,including cardiovascular disease.Thus,this study was aimed to explore the associations between Apo E gene polymorphisms and the cardiovascular complications of uremic patients on maintenance hemodialysis(MHD).Methods: A total of 189 uremic patients on MHD hospitalized in our hospital from June 2014 to June 2017 were recruited and all patients were in accordance with the diagnostic criteria of uremia issued by the Kidney Branch of Chinese Medical Association.An additional 165 healthy people during the same period were recruited as the control group.We collected the peripheral blood from all the subjects of experiment group and control group,and the peripheral mononuclear cells were isolated by Ficoll density gradient centrifugation followed by DNA extraction from these cells.The Apo E gene polymorphism was determined by Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Meanwhile,the demographic and laboratory data of these patients were also collected and the relationship between Apo E polymorphism and the cardiovascular complications of uremic patients on MHD was analyzed.Results: Adiponectin,Scr,BUN,TC,triglyceride and LDL-C in the experimental group were notably higher than those of the control group,while albumin and HDL-C were lower than those of the control group(all P < 0.05).Distribution frequencies of ?3/3 genotype and ?3 allele in the case group were remarkably lower than those of the control group(all P < 0.05),indicating that ?3/3 genotype and ?3 allele were the protective factors of cardiovascular complication for uremic patients on MHD.Distribution frequencies of ?4/3 genotype and ?4 allele in the case group were notably higher than those of the control group(all P < 0.05),suggesting that ?4/3 genotype and ?4 allele were risk factors.ESRD patients on MHD in the ?4 group were more likely to have complications of hypotension,hypertension,coronary heart disease and chronic cardiac insufficiency when compared with patients in other groups(all P < 0.05),whereas patients in the ?3 group had less chance to have the above complications than patients in the ?2 and ?4 groups(all P < 0.05).The results of logistic regression revealed that ?3 genotypes were the protective factors of cardiovascular complication for ESRD patients on MHD(P=0.042),while the ?4 genotypes were the risk factors(P=0.01).Conclusions: Our study provides evidence that Apo E gene polymorphisms had effect on cardiovascular complications of ESRD patients on MHD and Apo E ?4 genotypes and allele were the risk factors.These findings provide clinical significance for preventing and treating cardiovascular complications of uremia MHD patients.