APOLIPOPROTEIN E (APOE) GENE POLYMORPHISMS AND THEIR ASSOCIATION WITH CARDIOVASCULAR DISEASE (CVD) IN TYPE 2 DIABETES MELLITUS (T2DM) Apolipoprotein E (ApoE) is well known for its crucial role in lipid metabolism and is associated with an increased risk of cardiovascular disease (CVD) among subjects with type 2 diabetes mellitus (T2DM). Various apolipoprotein gene families have been determined, including APO (A-I), APO (A-II), APO (A-IV), APO (C-1), APO (C-II), APO (C-III), and APOE. A total of 3,597 nucleotides are encoded by the APOE gene, with four exons and three introns, constituting a polypeptide with 299 amino acids. The current study embarks on linking APOE gene polymorphisms with CVD among patients diagnosed with T2DM. This cross-sectional study involved 101 subjects with specific inclusion and exclusion criteria. The participants were separated into two groups, T2DM (n = 59) and T2DM with CVD (n = 42). Comparative analyses of clinical and biochemical characteristics were performed using student’s t-test and Pearson’s chi-square test (x2). Univariate and multivariate analyses were applied to establish the relationship between APOE gene polymorphisms with ischemic heart disease. The ε3/ε3 genotype was the most prevalent among both groups. The ε3/ε3 genotype (AOR= 0.052; 95% CI = 0.003-0.792; p = 0.033), ε3 allele (AOR = 34.83; 95% CI = 1.118-1085.134; p = 0.043), systolic blood pressure (SBP) (AOR = 1.046; 95% CI = 1.002-1.091; p = 0.042), and HbA1c (AOR = 2.286; 95% CI = 1.577-3.314; p < 0.001) were significantly associated with CVD. The ε3/ε3 genotype was also significantly associated with the lipid parameter, low density lipoprotein cholesterol (LDLc) (p = 0.011). Most T2DM patients presented with ε3 allele which may affect lipid profiles and the risk of CVD disease. This highlights the need to establish APOE as a likely predictive gene for CVD disease in T2DM subjects.

Heart Failure with Preserved Ejection Fraction (HFpEF) is becoming more common as the United States (U.S.A) population ages, along with the present of obesity pandemic. In general, HFpEF is the most common type of heart failure (HF) found in general population, however, the elderly, especially women are mostly suffering from it. It is primarily caused by obesity, hypertension, coronary artery disease, and diabetes. Obesity is frequent in individuals with HFpEF. However, it may constitute a distinct phenotype of HFpEF, with distinct hemodynamic and anatomical problems. Obesity causes a systemic inflammatory response which can lead to cardiac fibrosis and endothelial dysfunction. Because most obese patients are still excluded from HFpEF clinical trials, further research is needed to evaluate the role of pharmacologic and interventional treatments in this expanding group. Thus, this review study will aid in the understanding of HFpEF and its association with obesity.
Heart Failure, Diastolic