Association of PPARγ2 gene variant Pro12Ala polymorphism with hypertension and obesity in the aboriginal Qatari population known for being consanguineous

The PPARGC1A Is the Gene Responsible for Thrifty Metabolism Related Metabolic Diseases: A Scoping Review

The "thrifty genotype" hypothesis has thus far described the relationship between specific genes and the population's resilience to food scarcity circumstances, but its link to the widespread prevalence of genetic diseases and metabolic syndrome has not been adequately mapped. The purpose of the study was to discover genes responsible for thrifty metabolism. A systematic search with keywords was performed for relevant titles. This study used the article's database published by Pubmed, Proquest, and EBSCO from January, 2009 to September, 2022. Out of 418 papers screened for eligibility, the final evaluation determined that five studies should be included in the analysis. Results indicated that PPARGC1A Gly482Ser led to high BMI in the Tongans population but was unrelated to the onset of type 2 diabetes mellitus, but this was not the case in the Maori population. Significantly differing frequencies of PPAR C1431T and Pro12Ala gene polymorphisms were observed in the Iranian population. GWAS identification of additional genes in Asian and European populations did not produce consistent findings. As a summary, PPARGC1A Gly482Ser addresses as the gene responsible for thrifty metabolism in the Pacific population although some studies show inconsistent results.

Prevalence of hypertension and pre-hypertension in the Middle East region: a systematic review & meta-analysis

Hypertension is a leading cause of mortality and morbidity globally. This study aimed to obtain an overall regional estimate of the prevalence of hypertension and pre-hypertension and present the disease pattern based on the age and time in the Middle East region. We searched PubMed, Google Scholar, Medline for articles on the prevalence of hypertension, pre-hypertension among countries of the Middle East region from 1999 to 2019. STATA-14 was used to analyze the data. Data were pooled using a random-effects meta-analysis model, and heterogeneity between studies was assessed using I² test and subgroup analysis. A total of eighty-three studies with 479816 participants met the criteria for inclusion in the meta-analysis process. The overall prevalence of hypertension and pre-hypertension in the Middle East region were 24.36% (95% CI: 19.06-31.14) and 28. 60% (95% CI: 24.19-33.80), respectively. An increasing trend in the prevalence of hypertension was observed with the increasing age. The prevalence of hypertension in the ≤ 49-year-old age group was 17.13% (95% CI: 13.79-21.27) and in people over 60 years was 61.24% (95% CI: 55.30-67.81) (P < 0.001). This pattern has been similar among both males and females. On the other hand, a decreasing trend in the prevalence of pre-hypertension was observed with the increasing age. The increasing trend in the prevalence of hypertension and decreasing trend in the prevalence of pre-hypertension with age are significant concerns in the Middle East region. Screening for the prevention and control of hypertension should prioritize public health programs.

Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control

Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I² test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I² = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I² = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I² = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I² = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I² = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.

Gene variants and haplotypes of Vitamin D biosynthesis, transport, and function in preeclampsia

Objective: To find whether the gene variants and haplotypes of cytochrome (CYP) 27B1 (1α-hydroxylase), group-specific component (GC) that is a vitamin D binding protein, vitamin D receptor (VDR), peroxisome proliferator-activated receptor γ (PPARγ) and retinoid-X receptor (RXR) affect the risk of preeclampsia. Methods: In a case-control study 100 women with preeclampsia and 100 healthy pregnant women were investigated for gene variants and haplotypes of vitamin D biosynthesis, transport, and function using the polymerase chain reaction-restriction fragment length polymorphism method. Results: The frequency of gene variants of PPARγ Pro12Ala and RXR -α (A/G, rs749759) were not significantly different comparing patients and controls. The TT genotype of CYP 27B1 (G > T) was associated with 2.2-fold (95% CI 1.04-4.7, p = 0.039) increased risk of early-onset preeclampsia. Also, the TT genotype of GC rs7041 (T > G) increased the risk of preeclampsia [OR = 2.13 (95% CI 1.09-4.17, p = 0.027)]. The VDR ApaI GT genotype elevated susceptibility to preeclampsia (OR = 2.55, p = 0.04). Further, the presence of VDR ApaI GT+TT genotype was associated with higher levels of body mass index, and systolic blood pressure, and lower level of 25 (OH)-D3. In the presence of haplotype CYP T, VDR T, and RXR A (TTA) compared to haplotype GTG the risk of preeclampsia was 6.71-fold (p = 0.044). Conclusions: The present study indicated an association between the CYP 27B1, GC, and VDR ApaI variants with the risk of preeclampsia. Also, the variants of the latter polymorphism influenced BMI, blood pressure, and vitamin D levels.

Qatari Genotype May Contribute to Complications in Type 2 Diabetes

OBJECTIVE

There is increasing evidence of a strong genetic component in type 2 diabetes (T2DM) that may contribute to diabetes complications. Given the high prevalence of diabetes with its associated complications in the Middle East, we sought to determine if the genotype within a Middle East population may be contributory. Therefore, three genotype-based Qatari ancestral groups, Q1 Arab Bedouin, Q2 Asian/Persian, and Q3 sub-Saharan African, with a fourth admixed group were correlated with T2DM prevalence and its complications to determine if they differed between the 4 Qatari ancestries, particularly for the SLMAP allele-associated diabetic retinopathy.

METHODS

In this cross-sectional study, 398 Qatari subjects, 220 with and 178 without T2DM, were genotyped by Affymetrix 500k SNP arrays. Ancestry was correlated with diabetes complications.

RESULTS

398 subjects were included, the mean age was 49.8 years, and 56.8% were male. The genotype-based ancestry and T2DM prevalence were as follows: 164 (41.2%) with ancestry Q1, 60.4% with T2DM; 149 (37.4%) with ancestry Q2, 49.7% with T2DM; 31 (7.8%) with ancestry Q3, 61.3% with T2DM; and 54 (13.6%) with "admixed" ancestry, 51.9% with T2DM. For patients with diabetes, hypertension (p < 0.035) and retinopathy (p < 0.016) were greater in the Q3 ancestry.

CONCLUSION

These data suggest that the genotype may contribute to complication risk, as exemplified by the increase in hypertension and retinopathy in the Q3 ancestry, though the SLMAP allele was not implicated; however, diabetes prevalence did not differ between the four Qatari ancestries.

Genetic polymorphisms of PPAR genes and human cancers: evidence for gene-environment interactions

Peroxisome proliferator-activated receptors (PPARs) are nuclear transcription factors that play a role in lipid metabolism, cell proliferation, terminal differentiation, apoptosis, and inflammation. Although several cancer models have been suggested to explain PPARs' involvement in tumorigenesis, however, their role is still unclear. In this review, we examined associations of the different PPARs, polymorphisms and various types of cancer with a focus on gene-environment interactions. Reviewed evidence suggests that functional genetic variants of the different PPARs may modulate the relationship between environmental exposure and cancer risk. In addition, this report unveils the scarcity of reliable quantitative environmental exposure data when examining these interactions, and the current gaps in studying gene-environment interactions in many types of cancer, particularly colorectal, prostate, and bladder cancers.

Association between peroxisome proliferator-activated receptor γ-2 gene Pro12Ala polymorphisms and risk of hypertension: an updated meta-analysis

Previous studies investigate the relationship between peroxisome proliferator-activated receptor γ-2 (PPAR) gene Pro12Ala polymorphisms and risk of hypertension. However, the number of available studies was extremely limited. We updated this evidence and gave more significant results. We performed comprehensive computer-based searches in the PubMed, Web of Science, Embase, Google Scholar, the Cochrane library, Wanfang database, China National Knowledge Infrastructure, and China Biological Medicine Database. All studies that reported the association between the PPARγ2Pro12Ala polymorphisms and hypertension were identified. Twenty-one studies were finally included in the present study. In the domain model, the PPARγ1Pro12Ala polymorphism was not associated with hypertension (odds ratio (OR) = 0.85, 95% confidence interval (CI): 0.71-1.03, P=0.108). The significant relationship was found in the recessive model (OR = 0.67, 95% CI: 0.53-0.85), in the additive model (OR = 0.61, 95% CI: 0.48-0.77), and in the allele genetic model (OR = 0.81, 95% CI: 0.66-0.99). Subgroup analysis indicated that the PPARγ1Pro12Ala polymorphism from the all gene models was also not related to the risk of hypertension in Caucasians. In Asians, however, the results (P=0.002; I² = 57.6%) suggested a significant relationship between PPARγ1Pro12Ala and hypertension in the domain model (OR = 0.80, 95% CI: 0.65-0.99), in the recessive model (OR = 0.57, 95% CI: 0.44-0.75), in the additive model (OR = 0.51, 95% CI: 0.39-0.66), and in the allele model (OR = 0.75, 95% CI: 0.60-0.94). The PPARγ1Pro12Ala polymorphism could affect the risk of primary hypertension amongst Asians. The A allele gene was a protective genotype for primary hypertension. The PPARγ1Pro12Ala polymorphism was not associated with hypertension amongst Caucasians.

Current status of stroke in Qatar: Including data from the BRAINS study

BACKGROUND

Qatar is located on the north-eastern coast of the Arabian Peninsula. Qatari natives account for less than 15% of the population while the largest migrant group comprising 60% derives from South Asia. Despite projections that stroke burden in Qatar will increase with population ageing, epidemiological studies focusing on stroke in Qatar are relatively scarce.

METHOD

We reviewed the available epidemiological publications relating to Qatar. In addition, we have added to this knowledge by incorporating Qatari data from the on-going Bio-Repository of DNA in Stroke, an independent multinational database of stroke patients.

RESULTS

Qatar has low reported incidence and mortality rates of 58 and 9.17 per 100,000 per year, respectively, which may be explained by its middle-aged migrant worker majority population. Correspondingly, South Asian migrants in Qatar suffered younger strokes than Qatari natives (48.7 vs 63.4 years, P < 0.001). Among the most common risk factors identified in stroke patients were hypertension (77.9%), diabetes (43.8%) and hypercholesterolemia (28.5%). Ischaemic stroke was the most frequent subtype amongst migrant South Asians (71.1%). The majority of stroke cases had computed tomography and/or magnetic resonance imaging scans, but only 11.1% of ischaemic strokes were thrombolysed. Qataris on one-year follow up were more often found to have died (6.5% vs 0.3%) and had further stroke/transient ischaemic attack events (17.4% vs 6.4%, P = 0.009) compared to South Asians.

CONCLUSION

The burden of stroke is increasing in Qatar, and considerable disparities are observed between the native and migrant populations which likely will require different approaches to management by its healthcare system.

Central obesity and body fat, but not body mass index, are associated with the Pro12Ala polymorphism in the peroxisome proliferator-activated receptor γ gene in a population with a high consumption of saturated and trans-fatty acids

The relationship of the Pro12Ala polymorphism in the peroxisome proliferator-activated receptor γ (PPARγ) gene with obesity and its modulation by dietary fat has been proposed, but the few studies addressing this issue have yielded controversial results. In a Mexican population characterized by high-fat consumption, we hypothesized that the Pro12Ala PPARγ genotype is related to obesity and this relationship is modulated by intake of saturated fatty acids (SFAs) and trans-fatty acids (TFAs). We recruited 69 adults for this cross-sectional study. The Pro12Ala PPARγ polymorphism was determined from blood genomic DNA by using real-time polymerase chain reaction. Univariate and multivariate logistic regression analyses were performed. Pro12Ala showed a positive association with central obesity (adjusted odds ratio, 7.38; 95% confidence interval, 1.19-45.77; P = .032) and percentage of body fat (%BF; adjusted odds ratio, 1.08; 95% confidence interval, 1.00-1.17; P = .048), suggesting that Pro12Ala carriers are more likely to have central obesity and a higher %BF than Pro12Pro carriers. A modifying effect was observed for the SFAs strata: we found a significant association between the Pro12Ala polymorphism and %BF in the high-SFA-intake stratum (P < .04), but not in the low-intake stratum (P > .7). No modifying effect was observed for the TFAs strata. In addition, the impact of total energy intake on obesity in Pro12Ala carriers seemed to be stronger than that in the wild-type genotype carriers. As hypothesized, our data demonstrated a relationship between the Pro12Ala PPARγ polymorphism and the presence of obesity, which is modulated by SFA intake but not TFA intake.

Quantitative evaluation of PPAR-γ2 Pro12Ala polymorphism with hypertension

BACKGROUND

The peroxisome proliferator-activated receptor γ2 (PPARγ2)Pro12Ala polymorphism has been reported to be associated with hypertension. However, relevant studies have shown inconsistent results.

METHODS

To quantitatively evaluate the relationship between the PPARγ2Pro12Ala polymorphism and hypertension risk, we conducted a meta-analysis based on all available studies selected from Scopus, Web of Science, PubMed, Chinese National Knowledge Infrastructure, and Wanfang databases.

RESULTS

In all, 13 studies were finally included in this meta-analysis. In the allelic model (Ala vs. Pro), the Ala allele of PPARγ2 Pro12Ala polymorphism was associated with hypertension (Odds Ratio [OR] = 0.723, 95% confidence interval [CI] = 0.607-0.861). Sensitivity analysis and exclusion of studies with poor quality scores or controls complicated by other diseases confirmed the validity of this association. Moreover, the PPARγ2Pro12Ala polymorphism was associated with hypertension in the codominant (OR = 0.710, 95% CI = 0.626-0.806), recessive (OR = 0.561, 95% CI = 0.418-0.754), and dominant (OR = 0.693, 95% CI = 0.577-0.833) models.

CONCLUSION

The Ala allele appears to have a protective effect against hypertension and a dominant function.

Associations between PPARG polymorphisms and the risk of essential hypertension

Background

Peroxisome proliferator-activated receptor gamma (PPARG) plays an important role in the pathogenesis and maintenance of essential hypertension (EH). It has been suggested that polymorphisms of PPARG are associated with the risk of EH. However, findings to date remain controversial. To elucidate the associations between the PPARG Pro12Ala and C161T polymorphisms and EH risk, a meta-analysis was carried out.

Methods

A comprehensive literature search of PubMed, Embase, CNKI (Chinese National Knowledge Infrastructure), VIP and Wanfang databases was conducted. The pooled odds ratios (ORs) and 95% confidence interval (CI) were calculated to estimate the size of the effect using the random-effects model. At the same time, the pooled standardized mean difference (SMD) with 95% CI was used for the meta-analysis of the PPARG Pro12Ala polymorphism and blood pressure.

Results

Finally, Fifteen papers (seventeen studies) including 4,151 cases and 4,997 controls to evaluate the association of the PPARGPro12Ala polymorphism and EH risk, were included in this study. Overall, the results suggested that Ala allele was associated with the decreased EH risk (for allelic model, OR = 0.757, 95%CI: 0.624–0.918, P = 0.005; for dominant model, OR = 0.771, 95%CI: 0.627–0.946, P = 0.013). The subgroup analysis stratified by ethnicity showed that the significant association between the PPARG Pro12Ala polymorphism and EH was only detected in the Asian subgroup. There was no difference in blood pressure values between Ala carriers and non-carriers. For the C161T polymorphism, only 5 studies comprising 1,118 cases and 1,357 controls met the inclusion criteria. The overall results showed that the PPARG C161T polymorphism was not associated with the risk of EH. But in the subgroup analysis, we found that the PPARG C161T polymorphism significantly associated with the risk of EH in the Asian subgroup (for allelic model, OR = 0.719, 95% CI: 0.537–0.963, P = 0.027; for dominant model, OR = 0.653, 95% CI: 0.439–0.972, P = 0.036).

Conclusion

Our meta-analysis suggested that the PPARG polymorphisms might be associated with the risk of EH.

Effect of Ramadan fasting on diabetes mellitus: a population-based study in Qatar

BACKGROUND

Over one billion Muslims fast worldwide during the month of Ramadan. Fasting during Ramadan is a radical change in lifestyle for the period of a lunar month, and it might affect the biochemical parameters among diabetic patients.

AIM

This study aimed to investigate the effect of Ramadan fasting on the blood levels of glucose, glycated hemoglobin (HbA1c), and lipid profile among diabetic patients observing fast during the Ramadan.

PATIENTS AND METHODS

An observational study recruiting 1301 Muslim diabetic patients above 18 years age was conducted in diabetic outpatient clinic of Hamad General Hospital, Hamad Medical Corporation, and Primary Health Care Center, Qatar, from July 2012 to September 2013. Data on sociodemographic characteristics (age, sex, nationality, marital status, education level, and occupation) and lifestyle habits (smoking and physical activity), blood pressures, and anthropometric measurements were obtained by a face-to-face interview and measurement using a structured questionnaire. Blood samples were collected for testing glucose, glycosylated hemoglobin (HbA1C), lipid profile, urea, and creatinine (by the licensed research assistants).

RESULTS

Slightly less than half of the participants were overweight (BMI: 25-29.9). Significantly higher proportion of female participants were obese as compared with male participants (P<0.001). Among both male participants and female participants, the average level of blood glucose, HbA1c, total cholesterol, low-density and high-density lipoprotein cholesterol, triglycerides, albumin, bilirubin, uric acid, and systolic and diastolic blood pressures were significantly lower during the Ramadan as compared with before Ramadan (P<0.001 each).

CONCLUSION

Results revealed that fasting during Ramadan is significantly associated with decrease in blood lipid profile, blood pressures, glucose, and HbA1C level among diabetic patients. Muslim diabetic patients after the consultation of their primary physician can fast during the month of Ramadan and it might be beneficial for their health.