Screening for insulin receptor gene DNA polymorphisms associated with glucose intolerance in a Scandinavian population

Genetics of non-insulin-dependent (type-II) diabetes mellitus

Both genetic and environmental factors contribute to the etiology of non-insulin-dependent diabetes. The genetic component is heterogeneous and in some patients is probably complex, involving multiple genes. Specific genetic defects have been identified for rate monogenic forms of NIDDM: maturity-onset diabetes of the young, or MODY (which is due to glucokinase mutations in about 40% of families), syndromes of extreme insulin resistance (which often involve the insulin receptor), and diabetes-deafness syndromes (with defects in mitochondrial genes). In contrast, the genes involved in common forms of NIDDM are still uncertain. Mutations have been extensively searched in genes regulating insulin signaling and secretion. Some evidence of involvement has been produced for insulin-receptor substrate-1, glycogen synthase, the glucagon receptor, a ras-related protein (Rad), histocompatibility antigens, PC-1, and fatty acid binding protein, but the contributions of these genes to NIDDM is probably small. Other candidate genes (e.g. insulin, insulin receptor, glucose transporters) have been excluded as major diabetogenes. New insights are expected in the near future from the systematic scanning of the genome for linkage with NIDDM.

DNA polymorphisms in the human tyrosine hydroxylase/insulin/insulin-like growth factor II chromosomal region in relation to glucose and insulin responses

The feasibility of disease association studies using polymorphic DNA markers in the tyrosine hydroxylase/insulin/insulin-like growth factor II chromosomal region was indicated by a high degree of linkage disequilibrium found in haplotypes. Haplotypes were resolved in the parents from Scandinavian nuclear families by studying the segregation of eight DNA polymorphisms. Comparison of observed vs expected frequencies of haplotypes, as well as pairwise measures of linkage disequilibrium, indicated a high degree of linkage disequilibrium. Five restriction fragment length polymorphisms linked to the tyrosine hydroxylase/insulin/insulin growth factor II region of chromosome 11 were investigated in relation to Type 2 (non-insulin-dependent) diabetes mellitus, and to glucose and insulin responses to glucose infusion in healthy subjects. No significant differences in genotype frequencies between Type 2 diabetic (n = 53) and healthy subjects (n = 106) were found. A significant association (p < 0.001) was initially found between genotypes defined by a PstI polymorphism located 5' of the tyrosine hydroxylase gene and the early glucose response to a standardized glucose infusion test in healthy subjects. However, a follow-up study of 112 healthy individuals failed to confirm this finding.

Molecular studies of the genetics of non-insulin-dependent diabetes mellitus

Non-insulin-dependent mellitus (NIDDM) is a common, multifactorial disease with a significant genetic component to disease susceptibility. Biometrical analysis of family data has consistently found evidence of the action of a major gene in determining susceptibility to NIDDM in families. However, the identity of the gene or genes that contribute to NIDDM in the general population is still not known. Recent advances in molecular biology have given investigators access to a number of plausible candidate genes for NIDDM and these have been used as test loci in association and linkage studies with inconsistent results. A review of the candidate gene studies in NIDDM suggests that the failure of these studies to identify specific loci involved in conferring susceptibility to NIDDM is, in part, due to failure to incorporate a number of biological features of the disease. The frequency of NIDDM in the population suggests that the alleles involved in NIDDM are common and their individual impact too small to be detected by simple single locus methods of analysis. Studies of other phenotypic forms of diabetes mellitus suggest that susceptibility to NIDDM is probably determined by alleles at more than one locus acting independently or in concert. The evolutionary history of certain populations may have isolated alleles conferring susceptibility to NIDDM in ethnically defined populations at high risk of NIDDM. These populations may provide a unique opportunity to identify specific genes involved in the complex etiology of NIDDM. © 1993 Wiley-Liss, Inc.

DNA haplotype analysis suggests linkage disequilibrium in the human insulin receptor gene

Haplotypes of the insulin receptor gene were resolved in parents from Scandinavian nuclear families by studying the segregation of seven restriction fragment length polymorphisms (RFLPs). Of 97 unrelated parents, 41 had non-insulin-dependent diabetes mellitus (NIDDM). Considerable linkage disequilibrium in the region of the insulin receptor gene was found. Pairwise non-random associations were found between proximate RFLP sites, indicating the absence of recombinational hot spots between these sites. Thus, association studies between DNA polymorphisms at this locus and disease susceptibility genes could well be feasible in this population. Differences in the distribution of insulin receptor haplotypes were examined between NIDDM patients and healthy subjects. However, the differences observed were not statistically significant.