Non-insulin-dependent diabetes mellitus (NIDDM) confers myocardial infarction (MI) risk unexplained by known factors. In 356 NIDDM patients and 1,087 people with normal glucose tolerance, we investigated the association between MI risk and polymorphism at codon 360 in the apolipoprotein A-IV (apoA-IV) gene. During 1984–1992, MI was diagnosed in 84 diabetic and in 106 nondiabetic people. The risk of MI did not differ by apoA-IV phenotype in nondiabetic people; however, in NIDDM patients, those with the apoA-IV 1–2 phenotype had 2.8 (95% confidence interval: 1.4–5.6) higher MI risk than those with the 1–1 phenotype, adjusting for age, gender, ethnicity, hypertension, smoking, body mass index, fat centrality, and low-density lipoprotein and high-density lipoprotein cholesterol. The risk of MI was particularly high in obese NIDDM patients with the apoA-IV 1–2 phenotype: 5.1 (2.4–11.2) times that in obese apoA-IV 1–1 NIDDM patients and 7.7 (3.6–16.7) times that in lean nondiabetic people. The effect of apoA-IV 1–2 did not appear to be a part of the insulin-resistance syndrome nor was it dependent on diabetes duration or control. One half of the excess MI risk in the diabetic population studied was explained by the apoA-IV 1–2 phenotype. These results indicate that ∼ 17% of NIDDM patients have a high MI risk apoA-IV phenotype that is particularly deleterious in obese patients.
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December 01 1994
ApoA-IV Polymorphism Associated With Myocardial Infarction in Obese NIDDM Patients: The San Luis Valley Diabetes Study
Marian Rewers;
Marian Rewers
Department of Preventive Medicine and Biometrics, University of Colorado
Denver, Colorado
Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Pittsburgh, Pennsylvania
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M Ilyas Kamboh;
M Ilyas Kamboh
Department of Preventive Medicine and Biometrics, University of Colorado
Denver, Colorado
Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Pittsburgh, Pennsylvania
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Sharon Hoag;
Sharon Hoag
Department of Preventive Medicine and Biometrics, University of Colorado
Denver, Colorado
Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Pittsburgh, Pennsylvania
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Susan M Shetterly;
Susan M Shetterly
Department of Preventive Medicine and Biometrics, University of Colorado
Denver, Colorado
Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Pittsburgh, Pennsylvania
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Robert E Ferrell;
Robert E Ferrell
Department of Preventive Medicine and Biometrics, University of Colorado
Denver, Colorado
Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Pittsburgh, Pennsylvania
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Richard F Hamman
Richard F Hamman
Department of Preventive Medicine and Biometrics, University of Colorado
Denver, Colorado
Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Pittsburgh, Pennsylvania
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Address correspondence and reprint requests to Dr. Marian Rewers, Department of Preventive Medicine and Biometrics, School of Medicine, University of Colorado, Box C-245, 4200 E. 9th Ave., Denver, CO 80262.
Diabetes 1994;43(12):1485–1489
Article history
Received:
August 04 1993
Revision Received:
August 04 1994
Accepted:
August 04 1994
PubMed:
7958503
Citation
Marian Rewers, M Ilyas Kamboh, Sharon Hoag, Susan M Shetterly, Robert E Ferrell, Richard F Hamman; ApoA-IV Polymorphism Associated With Myocardial Infarction in Obese NIDDM Patients: The San Luis Valley Diabetes Study. Diabetes 1 December 1994; 43 (12): 1485–1489. https://doi.org/10.2337/diab.43.12.1485
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