Apolipoprotein E genotype is a determinant of low-density lipoprotein cholesterol and of its response to a low-cholesterol diet in type 1 diabetic patients with elevated urinary albumin excretion

The effect of the apolipoprotein (apo) E genotype on the lipoprotein response to a 1 year low cholesterol diet (200 mg cholesterol per day) was evaluated in 36 patients with Type 1 diabetes mellitus with albuminuria between 10 and 200 mu g min(-1). Apo E genotype was characterized by polymerase chain reaction and restriction isotyping. In 11 IDDM patients with at least one epsilon 4 allele (apo E4 group), baseline serum total and low density lipoprotein (LDL) cholesterol were higher (p <0.05 for both) than in 25 patients without an epsilon 4 allele and with at least one epsilon 3 allele (apo E3 group). Dietary counselling resulted in a similar decrease in cholesterol intake in both groups, whereas linoleic acid did not change. in the apo E4 group, serum total and LDL cholesterol at follow-up fell (p <0.01 for both) to levels that were not different from those in the apo E3 group, and the changes in these parameters were greater (p