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Benítez-Camacho J, Ballesteros A, Beltrán-Camacho L, Rojas-Torres M, Rosal-Vela A, Jimenez-Palomares M, Sanchez-Gomar I, Durán-Ruiz MC. Endothelial progenitor cells as biomarkers of diabetes-related cardiovascular complications. Stem Cell Res Ther 2023; 14:324. [PMID: 37950274 PMCID: PMC10636846 DOI: 10.1186/s13287-023-03537-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023] Open
Abstract
Diabetes mellitus (DM) constitutes a chronic metabolic disease characterized by elevated levels of blood glucose which can also lead to the so-called diabetic vascular complications (DVCs), responsible for most of the morbidity, hospitalizations and death registered in these patients. Currently, different approaches to prevent or reduce DM and its DVCs have focused on reducing blood sugar levels, cholesterol management or even changes in lifestyle habits. However, even the strictest glycaemic control strategies are not always sufficient to prevent the development of DVCs, which reflects the need to identify reliable biomarkers capable of predicting further vascular complications in diabetic patients. Endothelial progenitor cells (EPCs), widely known for their potential applications in cell therapy due to their regenerative properties, may be used as differential markers in DVCs, considering that the number and functionality of these cells are affected under the pathological environments related to DM. Besides, drugs commonly used with DM patients may influence the level or behaviour of EPCs as a pleiotropic effect that could finally be decisive in the prognosis of the disease. In the current review, we have analysed the relationship between diabetes and DVCs, focusing on the potential use of EPCs as biomarkers of diabetes progression towards the development of major vascular complications. Moreover, the effects of different drugs on the number and function of EPCs have been also addressed.
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Affiliation(s)
- Josefa Benítez-Camacho
- Biomedicine, Biotechnology and Public Health Department, Science Faculty, Cádiz University, Torre Sur. Avda. República Saharaui S/N, Polígono Río San Pedro, Puerto Real, 11519, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain
| | - Antonio Ballesteros
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
| | - Lucía Beltrán-Camacho
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
- Cell Biology, Physiology and Immunology Department, Córdoba University, Córdoba, Spain
| | - Marta Rojas-Torres
- Biomedicine, Biotechnology and Public Health Department, Science Faculty, Cádiz University, Torre Sur. Avda. República Saharaui S/N, Polígono Río San Pedro, Puerto Real, 11519, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain
| | - Antonio Rosal-Vela
- Biomedicine, Biotechnology and Public Health Department, Science Faculty, Cádiz University, Torre Sur. Avda. República Saharaui S/N, Polígono Río San Pedro, Puerto Real, 11519, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain
| | - Margarita Jimenez-Palomares
- Biomedicine, Biotechnology and Public Health Department, Science Faculty, Cádiz University, Torre Sur. Avda. República Saharaui S/N, Polígono Río San Pedro, Puerto Real, 11519, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain
| | - Ismael Sanchez-Gomar
- Biomedicine, Biotechnology and Public Health Department, Science Faculty, Cádiz University, Torre Sur. Avda. República Saharaui S/N, Polígono Río San Pedro, Puerto Real, 11519, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain
| | - Mª Carmen Durán-Ruiz
- Biomedicine, Biotechnology and Public Health Department, Science Faculty, Cádiz University, Torre Sur. Avda. República Saharaui S/N, Polígono Río San Pedro, Puerto Real, 11519, Cádiz, Spain.
- Biomedical Research and Innovation Institute of Cadiz (INIBICA), Cádiz, Spain.
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Kim J, Jensen A, Ko S, Raghavan S, Phillips LS, Hung A, Sun Y, Zhou H, Reaven P, Zhou JJ. Systematic Heritability and Heritability Enrichment Analysis for Diabetes Complications in UK Biobank and ACCORD Studies. Diabetes 2022; 71:1137-1148. [PMID: 35133398 PMCID: PMC9044130 DOI: 10.2337/db21-0839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022]
Abstract
Diabetes-related complications reflect longstanding damage to small and large vessels throughout the body. In addition to the duration of diabetes and poor glycemic control, genetic factors are important contributors to the variability in the development of vascular complications. Early heritability studies found strong familial clustering of both macrovascular and microvascular complications. However, they were limited by small sample sizes and large phenotypic heterogeneity, leading to less accurate estimates. We take advantage of two independent studies-UK Biobank and the Action to Control Cardiovascular Risk in Diabetes trial-to survey the single nucleotide polymorphism heritability for diabetes microvascular (diabetic kidney disease and diabetic retinopathy) and macrovascular (cardiovascular events) complications. Heritability for diabetic kidney disease was estimated at 29%. The heritability estimate for microalbuminuria ranged from 24 to 60% and was 41% for macroalbuminuria. Heritability estimates of diabetic retinopathy ranged from 6 to 33%, depending on the phenotype definition. More severe diabetes retinopathy possessed higher genetic contributions. We show, for the first time, that rare variants account for much of the heritability of diabetic retinopathy. This study suggests that a large portion of the genetic risk of diabetes complications is yet to be discovered and emphasizes the need for additional genetic studies of diabetes complications.
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Affiliation(s)
- Juhyun Kim
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Aubrey Jensen
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA
| | - Seyoon Ko
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA
| | - Sridharan Raghavan
- University of Colorado School of Medicine, Aurora, CO
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO
| | - Lawrence S. Phillips
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA
- Atlanta Veterans Affairs Medical Center, Decatur, GA
| | - Adriana Hung
- Tennessee Valley Healthcare System and Vanderbilt University, Nashville, TN
| | - Yan Sun
- Department of Epidemiology, Emory University, Atlanta, GA
| | - Hua Zhou
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA
| | - Peter Reaven
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
| | - Jin J. Zhou
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA
- Phoenix Veterans Affairs Health Care System, Phoenix, AZ
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
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Scanlon PH. Improving the screening of risk factors in diabetic retinopathy. Expert Rev Endocrinol Metab 2022; 17:235-243. [PMID: 35730170 DOI: 10.1080/17446651.2022.2078305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/12/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION In 2002, Diabetic Retinopathy was reported as the leading cause of blindness in the working age group. The introduction of systematic screening programs in the UK has reduced visual loss and blindness due to diabetic retinopathy, but it does still occur with catastrophic consequences for the individual. AREAS COVERED The author conducted an ongoing search for articles relating to diabetic retinopathy since 2000 utilizing Zetoc Alert with keywords and contents page lists from relevant journals. This review covers the risk factors for loss of vision due to diabetic retinopathy and discusses ways in which the awareness of these risk factors can be used to further reduce visual loss. Some risk factors such as glycemic and B/P control are well known from landmark trials. This review has included these factors but concentrated more on the evidence behind those risk factors that are not so clearly defined or so well known. EXPERT OPINION The major risk factors are well known, but one continues to find that people with diabetes lose vision in situations in which a better awareness of the risks by both the individual with diabetes and the health workers involved may have prevented the visual loss.
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Affiliation(s)
- Peter H Scanlon
- Consultant Ophthalmologist, Department of Ophthalmologist, Gloucestershire Hospitals NHS Foundation Trust Cheltenham, UK
- National Clinical Lead, NHS Diabetic Eye Screening Programme (Ophthalmology), Public Health Commissioning and Operations, England
- Associate Professor, Nuffield Department of Clinical Neuroscience, University of Oxford, UK
- Visiting Professor, School of Health and Social Care, University of Gloucestershire, UK
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Bek T. The risk for developing vision threatening diabetic retinopathy is influenced by heredity to diabetes. Curr Eye Res 2022; 47:1322-1328. [PMID: 35435085 DOI: 10.1080/02713683.2022.2067564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: Clustering of vision threatening diabetic retinopathy within specific families can be the result of similarities in life style but may also be due to a common genetic background. An evaluation of the role of heredity for the development of diabetic retinopathy may help adjusting control intervals in screening programmes to each patient's individual risk profile.Methods: Survival analysis was used to study whether family history of diabetes among men and women with type 1 or type 2 diabetes together with the degree of heredity could be added as risk factors to improve the prediction of the risk for developing proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME). The study was conducted on data from 12,281 patients followed in the Aarhus area, Denmark, from January 1. 2003 to July 1. 2019.Results: The risk for developing PDR was significantly reduced 2-11 years after known onset of diabetes in the presence of female family members with type 1 diabetes, and the risk for developing DME significantly increased 4-24 years after onset of diabetes in the presence of family members with type 2 diabetes of any sex. These hereditary factors were independent of other studied risk factors such as previous cataract surgery, age of onset of diabetes, metabolic regulation and blood pressure.Conclusions: The presence of family members with diabetes affects the risk for developing vision threatening diabetic retinopathy and affects the risk for developing PDR and DME differently. This evidence may help individualizing the control intervals in screening programmes for diabetic retinopathy.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, DENMARK
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Behl T, Kumar K, Singh S, Sehgal A, Sachdeva M, Bhatia S, Al-Harrasi A, Buhas C, Teodora Judea-Pusta C, Negrut N, Alexandru Munteanu M, Brisc C, Bungau S. Unveiling the role of polyphenols in diabetic retinopathy. J Funct Foods 2021. [DOI: https://doi.org/10.1016/j.jff.2021.104608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Ng KKK, Cheung CYY, Lee CH, Fong CHY, Kwok KHM, Li KKW, Gangwani RA, Wong IYH, Woo YC, Chow WS, Yuen MMA, Wong RLC, Xu A, Wong DSH, Sham PC, Lam KSL. Possible Modifying Effect of Hemoglobin A1c on Genetic Susceptibility to Severe Diabetic Retinopathy in Patients With Type 2 Diabetes. Invest Ophthalmol Vis Sci 2021; 61:7. [PMID: 32756921 PMCID: PMC7441357 DOI: 10.1167/iovs.61.10.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose Glycemic control has been recognized as an important modifiable risk factor for diabetic retinopathy (DR). Whether hemoglobin A1c (HbA1c), as an indicator of glycemic control, could modify the genetic susceptibility to severe DR remains to be investigated. This study aimed to investigate whether HbA1c could modulate the genetic susceptibility to severe DR in Chinese patients with type 2 diabetes. Methods A total of 3,093 Chinese individuals with type 2 diabetes were included in the cross-sectional case-control study: 1,051 with sight-threatening DR (STDR) and 2,042 without STDR. Sixty-nine top-ranked single nucleotide polymorphisms (SNPs) identified from previous genome-wide association studies were examined for their associations with STDR and proliferative DR as a subgroup analysis. SNPs showing suggestive associations with DR were examined in the stratified analysis by dichotomized HbA1c (<7% vs. ≥7%). An interaction analysis was performed by including an interaction term of SNP × HbA1c in the regression model. Results Four SNPs showed suggestive associations with STDR. In the stratified analysis, patients with adequate glycemic control (HbA1c <7%) had a 42% lower risk of STDR for carrying each additional protective C allele of COL5A1 rs59126004 (P = 1.76 × 10−4; odds ratio, 0.58; 95% confidence interval, 0.44–0.77). rs59126004 demonstrated a significant interaction with dichotomized HbA1c on the risk of STDR (Pinteraction = 1.733 × 10−3). In the subgroup analysis for proliferative DR, the protective effect of rs59126004 was even more pronouncedly demonstrated (P = 8.35 × 10−5; odds ratio, 0.37; 95% confidence interval, 0.22–0.60) and it showed similar interactions with dichotomized HbA1c (Pinteraction = 1.729 × 10−3). Conclusions Our data provided evidence for possible interactions between HbA1c and COL5A1 rs59126004 on the risk of severe DR. These findings may provide new insight into the pathophysiologic mechanism of DR.
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Affiliation(s)
- Kelvin K K Ng
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Chloe Y Y Cheung
- Department of Medicine, The University of Hong Kong, Hong Kong,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong
| | - Chi-Ho Lee
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Carol H Y Fong
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Kelvin H M Kwok
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Kenneth K W Li
- Department of Ophthalmology, United Christian Hospital, Hong Kong
| | - Rita A Gangwani
- Department of Ophthalmology, The University of Hong Kong, Hong Kong
| | - Ian Y H Wong
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yu-Cho Woo
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Wing-Sun Chow
- Department of Medicine, The University of Hong Kong, Hong Kong
| | | | - Rachel L C Wong
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Aimin Xu
- Department of Medicine, The University of Hong Kong, Hong Kong,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong,Research Center of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong
| | - David S H Wong
- Department of Ophthalmology, The University of Hong Kong, Hong Kong
| | - Pak-Chung Sham
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Karen S L Lam
- Department of Medicine, The University of Hong Kong, Hong Kong,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong,Research Center of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong
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Zamorano LS, Calero Magaña P, García Cisneros E, Martínez AV, Martín LF. Cocoa olein glycerolysis with lipase Candida antarctica in a solvent free system. GRASAS Y ACEITES 2020. [DOI: 10.3989/gya.0794191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this paper we present the valorization of cocoa olein obtained from the acid fat-splitting of soapstocks. The aim is to develop a solvent free process (enzymatically catalyzed) to maximize the production of a final product with high content of monoglycerides (MAG) and diglycerides (DAG). The effect of the enzyme dose, glycerol content, reaction times as well as the modification of the raw material and pressure were studied. The yield of the reaction increased up to 90-95% when using a vacuum of 2-3 mbar at 65 °C, enough to evaporate the water which is generated as a by-product, an enzyme dose of 1% and molar ratio oil:glycerol of 1:2. The highest yield in terms of MAG and DAG production was obtained by starting from a raw material which was rich in free acidity (FFA), rendering oil with 33.4 and 44.2% MAG and DAG, respectively. Short reaction times (6-8 h) were observed compared to previously reported results (24 h).
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Abstract
Diabetes is one of the fastest growing diseases worldwide, projected to affect 693 million adults by 2045. Devastating macrovascular complications (cardiovascular disease) and microvascular complications (such as diabetic kidney disease, diabetic retinopathy and neuropathy) lead to increased mortality, blindness, kidney failure and an overall decreased quality of life in individuals with diabetes. Clinical risk factors and glycaemic control alone cannot predict the development of vascular complications; numerous genetic studies have demonstrated a clear genetic component to both diabetes and its complications. Early research aimed at identifying genetic determinants of diabetes complications relied on familial linkage analysis suited to strong-effect loci, candidate gene studies prone to false positives, and underpowered genome-wide association studies limited by sample size. The explosion of new genomic datasets, both in terms of biobanks and aggregation of worldwide cohorts, has more than doubled the number of genetic discoveries for both diabetes and diabetes complications. We focus herein on genetic discoveries for diabetes and diabetes complications, empowered primarily through genome-wide association studies, and emphasize the gaps in research for taking genomic discovery to the next level.
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Affiliation(s)
- Joanne B Cole
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA
| | - Jose C Florez
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
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Vujosevic S, Aldington SJ, Silva P, Hernández C, Scanlon P, Peto T, Simó R. Screening for diabetic retinopathy: new perspectives and challenges. Lancet Diabetes Endocrinol 2020; 8:337-347. [PMID: 32113513 DOI: 10.1016/s2213-8587(19)30411-5] [Citation(s) in RCA: 261] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/15/2022]
Abstract
Although the prevalence of all stages of diabetic retinopathy has been declining since 1980 in populations with improved diabetes control, the crude prevalence of visual impairment and blindness caused by diabetic retinopathy worldwide increased between 1990 and 2015, largely because of the increasing prevalence of type 2 diabetes, particularly in low-income and middle-income countries. Screening for diabetic retinopathy is essential to detect referable cases that need timely full ophthalmic examination and treatment to avoid permanent visual loss. In the past few years, personalised screening intervals that take into account several risk factors have been proposed, with good cost-effectiveness ratios. However, resources for nationwide screening programmes are scarce in many countries. New technologies, such as scanning confocal ophthalmology with ultrawide field imaging and handheld mobile devices, teleophthalmology for remote grading, and artificial intelligence for automated detection and classification of diabetic retinopathy, are changing screening strategies and improving cost-effectiveness. Additionally, emerging evidence suggests that retinal imaging could be useful for identifying individuals at risk of cardiovascular disease or cognitive impairment, which could expand the role of diabetic retinopathy screening beyond the prevention of sight-threatening disease.
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Affiliation(s)
- Stela Vujosevic
- Eye Unit, University Hospital Maggiore della Carità, Novara, Italy
| | - Stephen J Aldington
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Paolo Silva
- Beetham Eye Institute, Joslin Diabetes Centre, Harvard Medical School, Boston, MA, USA; Philippine Eye Research Institute, University of the Philippines, Manila, Philippines
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain; Department of Medicine and Endocrinology, Autonomous University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Peter Scanlon
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain; Department of Medicine and Endocrinology, Autonomous University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain.
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Liu C, Chen G, Bentley AR, Doumatey A, Zhou J, Adeyemo A, Yang J, Rotimi C. Genome-wide association study for proliferative diabetic retinopathy in Africans. NPJ Genom Med 2019; 4:20. [PMID: 31482010 PMCID: PMC6715701 DOI: 10.1038/s41525-019-0094-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 08/07/2019] [Indexed: 11/08/2022] Open
Abstract
Proliferative diabetic retinopathy (PDR) is a sight-threatening complication of diabetes that is associated with longer duration of diabetes and poor glycemic control under a genetic susceptibility background. Although GWAS of PDR have been conducted in Europeans and Asians, none has been done in continental Africans, a population at increased risk for PDR. Here, we report a GWAS of PDR among Africans. PDR cases (n = 64) were T2D patients with neovascularization in the retina and/or retinal detachment. Controls (n = 227) were T2D patients without listed eye complications despite high risk (T2D duration ≥10 years and fasting blood glucose >169 mg/dl). Replication was assessed in African Americans enrolled in the ARIC study. We identified 4 significant loci: WDR72, HLA-B, GAP43/RP11-326J18.1, and AL713866.1. At WDR72 the most strongly associated SNPs were rs12906891 (MAF = 0.071; p = 9.68 × 10-10; OR = 1.46, 95% CI [1.30,1.64]) and rs11070992 (MAF = 0.14; p = 4.23 × 10-8; OR = 1.28, 95%CI [1.17-1.40]). rs11070992 replicated in African Americans (p = 0.04). Variants in this gene have been associated with diabetic retinopathy, glycemic control, revascularization, and kidney disease.
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Affiliation(s)
- Chang Liu
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 10730 China
- Beijing Diabetes institute, Beijing, 100730 China
| | - Guanjie Chen
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
| | - Amy R. Bentley
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
| | - Ayo Doumatey
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
| | - Jie Zhou
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
| | - Adebowale Adeyemo
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
| | - Jinkui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 10730 China
- Beijing Diabetes institute, Beijing, 100730 China
| | - Charles Rotimi
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA
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Simó-Servat O, Hernández C, Simó R. Diabetic Retinopathy in the Context of Patients with Diabetes. Ophthalmic Res 2019; 62:211-217. [DOI: 10.1159/000499541] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/09/2019] [Indexed: 01/05/2023]
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McEwen MM, Pasvogel A, Elizondo-Pereo R, Meester I, Vargas-Villarreal J, González-Salazar F. Diabetes Self-Management Behaviors, Health Care Access, and Health Perception in Mexico-US Border States. DIABETES EDUCATOR 2019; 45:164-173. [PMID: 30741101 DOI: 10.1177/0145721719828952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of this study was to describe diabetes self-management behaviors, diabetes health care access, and health perception for Mexican adults and Hispanics residing in the Mexico-US border region. Methods This study used data from the Behavior Risk Factor Surveillance System (BRFSS) survey diabetes items (n = 26) to assess characteristics of Hispanics in 4 Arizona border counties (n = 216) and cross-sectional data from a modified BRFSS in a convenience sample of adults residing in Monterrey, Mexico (n = 351). Data were analyzed for descriptive statistics with SPSS. Results The Mexico cohort was younger than the Arizona cohort (59.36 [11.5] vs 65.54 [11.1], respectively) and the mean length of time with type 2 diabetes was similar. Less than 10% (9.7%) of the Arizona cohort reported never monitoring blood glucose compared to 22.5% of the Mexico cohort. The mean (SD) number of times in the past 12 months the Mexico cohort saw their health care provider was 9.09 (6.8) vs 4.49 (8.3) for the Arizona cohort. Despite provider access, there were differences in self-management behaviors between the cohorts. Conclusions Due to environmental and policy factors in the Mexico-US border region, there continues to be a gap in evidence-based practice and uptake of self-management behaviors for adults with diabetes. Resources such as the BRFSS and shared practice guidelines would bridge this gap.
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Affiliation(s)
- Marylyn M McEwen
- College of Nursing & Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Alice Pasvogel
- College of Nursing, University of Arizona, Tucson, Arizona
| | | | - Irene Meester
- Basic Sciences Department, University of Monterrey, Monterrey, NL, Mexico
| | - Javier Vargas-Villarreal
- Laboratory of Cellular Physiology, Northeast Center of Research, Mexican Institute of Social Security, Monterrey, NL, Mexico
| | - Francisco González-Salazar
- Basic Sciences Department, University of Monterrey, Monterrey, NL, Mexico
- Laboratory of Cellular Physiology, Northeast Center of Research, Mexican Institute of Social Security, Monterrey, NL, Mexico
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Ekberg NR, Eliasson S, Li YW, Zheng X, Chatzidionysiou K, Falhammar H, Gu HF, Catrina SB. Protective Effect of the HIF-1A Pro582Ser Polymorphism on Severe Diabetic Retinopathy. J Diabetes Res 2019; 2019:2936962. [PMID: 31214621 PMCID: PMC6535890 DOI: 10.1155/2019/2936962] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/18/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Hypoxia is central in the pathogenesis of diabetic retinopathy (DR). Hypoxia-inducible factor-1 (HIF-1) is the key mediator in cellular oxygen homeostasis that facilitates the adaptation to hypoxia. HIF-1 is repressed by hyperglycemia contributing by this to the development of complications in diabetes. Recent work has shown that the HIF-1A Pro582Ser polymorphism is more resistant to hyperglycemia-mediated repression, thus protecting against the development of diabetic nephropathy. In this study, we have investigated the effect of the HIF-1A Pro582Ser polymorphism on the development of DR and further dissected the mechanisms by which the polymorphism confers a relative resistance to the repressive effect of hyperglycemia. RESEARCH DESIGN AND METHOD 703 patients with type 1 diabetes mellitus from one endocrine department were included in the study. The degree of retinopathy was correlated to the HIF-1A Pro582Ser polymorphism. The effect of glucose on a stable HIF-1A construct with a Pro582Ser mutation was evaluated in vitro. RESULTS We identified a protective effect of HIF-1A Pro582Ser against developing severe DR with a risk reduction of 95%, even when adjusting for known risk factors for DR such as diabetes duration, hyperglycemia, and hypertension. The Pro582Ser mutation does not cancel the destabilizing effect of glucose but is followed by an increased transactivation activity even in high glucose concentrations. CONCLUSION The HIF-1A genetic polymorphism has a protective effect on the development of severe DR. Moreover, the relative resistance of the HIF-1A Pro582Ser polymorphism to the repressive effect of hyperglycemia is due to the transactivation activity rather than the protein stability of HIF-1α.
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Affiliation(s)
- Neda Rajamand Ekberg
- Department of Endocrinology Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Centrum for Diabetes, Academic Specialist Centrum, Stockholm, Sweden
| | - Sofie Eliasson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Young Wen Li
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Pharmacology, Guilin Medical University, Guilin, China
| | - Xiaowei Zheng
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Katerina Chatzidionysiou
- Department of Endocrinology Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Henrik Falhammar
- Department of Endocrinology Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Harvest F. Gu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Sergiu-Bogdan Catrina
- Department of Endocrinology Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Centrum for Diabetes, Academic Specialist Centrum, Stockholm, Sweden
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15
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Meng W, Shah KP, Pollack S, Toppila I, Hebert HL, McCarthy MI, Groop L, Ahlqvist E, Lyssenko V, Agardh E, Daniell M, Kaidonis G, Craig JE, Mitchell P, Liew G, Kifley A, Wang JJ, Christiansen MW, Jensen RA, Penman A, Hancock HA, Chen CJ, Correa A, Kuo JZ, Li X, Chen YDI, Rotter JI, Klein R, Klein B, Wong TY, Morris AD, Doney AS, Colhoun HM, Price AL, Burdon KP, Groop PH, Sandholm N, Grassi MA, Sobrin L, Palmer CN. A genome-wide association study suggests new evidence for an association of the NADPH Oxidase 4 (NOX4) gene with severe diabetic retinopathy in type 2 diabetes. Acta Ophthalmol 2018; 96:e811-e819. [PMID: 30178632 PMCID: PMC6263819 DOI: 10.1111/aos.13769] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/01/2018] [Indexed: 12/29/2022]
Abstract
Purpose Diabetic retinopathy is the most common eye complication in patients with diabetes. The purpose of this study is to identify genetic factors contributing to severe diabetic retinopathy. Methods A genome‐wide association approach was applied. In the Genetics of Diabetes Audit and Research in Tayside Scotland (GoDARTS) datasets, cases of severe diabetic retinopathy were defined as type 2 diabetic patients who were ever graded as having severe background retinopathy (Level R3) or proliferative retinopathy (Level R4) in at least one eye according to the Scottish Diabetic Retinopathy Grading Scheme or who were once treated by laser photocoagulation. Controls were diabetic individuals whose longitudinal retinopathy screening records were either normal (Level R0) or only with mild background retinopathy (Level R1) in both eyes. Significant Single Nucleotide Polymorphisms (SNPs) were taken forward for meta‐analysis using multiple Caucasian cohorts. Results Five hundred and sixty cases of type 2 diabetes with severe diabetic retinopathy and 4,106 controls were identified in the GoDARTS cohort. We revealed that rs3913535 in the NADPH Oxidase 4 (NOX4) gene reached a p value of 4.05 × 10−9. Two nearby SNPs, rs10765219 and rs11018670 also showed promising p values (p values = 7.41 × 10−8 and 1.23 × 10−8, respectively). In the meta‐analysis using multiple Caucasian cohorts (excluding GoDARTS), rs10765219 and rs11018670 showed associations for diabetic retinopathy (p = 0.003 and 0.007, respectively), while the p value of rs3913535 was not significant (p = 0.429). Conclusion This genome‐wide association study of severe diabetic retinopathy suggests new evidence for the involvement of the NOX4 gene.
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16
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Pinazo-Durán MD, Shoaie-Nia K, Sanz-González SM, Raga-Cervera J, García-Medina JJ, López-Gálvez MI, Galarreta-Mira D, Duarte L, Campos-Borges C, Zanón-Moreno V. Identification of new candidate genes for retinopathy in type 2 diabetics. Valencia Study on Diabetic Retinopathy (VSDR). Report number 3. ACTA ACUST UNITED AC 2018; 93:211-219. [PMID: 29398232 DOI: 10.1016/j.oftal.2017.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/06/2017] [Accepted: 12/14/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To identify genes involved in the pathogenic mechanisms of non-proliferative diabetic retinopathy (NPDR), among which include oxidative stress, extracellular matrix changes, and/or apoptosis, in order to evaluate the risk of developing this retinal disease in a type2 diabetic (DM2) population. MATERIAL AND METHODS A case-control study was carried out on 81 participants from the Valencia Study on Diabetic Retinopathy (VSDR) of both genders, with ages 25-85years. They were classified into: (i)DM2 group (n=49), with DR (+DR; n=14) and without DR (-DR; n=35), and (ii)control group (GC; n=32). The protocols included a personal interview, standardised ophthalmological examination, and blood collection (to analyse the DNA for determining the gene expression (TP53, MMP9, and SLC23A2) in the study groups. Statistical analyses were performed using the SPSS v22.0 program. RESULTS The TP53 and MMP9 genes showed a higher expression in the DM2 group compared to the GC, although the difference was only significant for the MMP9 gene (TP53: 10.40±1.20 vs. 8.23±1.36, P=.084; MMP9: 1.45±0.16 vs. 0.95±0.16, P=.036), and the SLC23A2 gene showed a significant lower expression in the DM2 vs CG (5.58±0.64 vs. 11.66±1.90, P=.026). When sub-dividing the DM2 group according to the presence of retinopathy, the expression of the TP53, MMP9 and SLC23A2 genes showed significant differences between the DM2-RD, DM2+RD and GC groups (TP53: 9.95±1.47 vs. 11.52±2.05 vs. 8.23±1.36, P=.038; MMP9: 1.47±0.20 vs. 1.41±0.27 vs. 0.95±0.16, P=.021; SLC23A2: 5.61±0.77 vs. 5.51±1.21 vs. 11.66±1.90, P=.018). CONCLUSIONS Genes involved in extracellular matrix integrity (MMP9) and/or apoptosis (TP53), could be considered potential markers of susceptibility to the development/progression of NPDR. Interestingly, the SLC232A2 gene (ascorbic acid transporter) can be considered a protector of the risk of the development/progression of the retinopathy.
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Affiliation(s)
- M D Pinazo-Durán
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Red Temática de Investigación Cooperativa de Patología ocular OFTARED, Instituto de Salud Carlos III, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España.
| | - K Shoaie-Nia
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - S M Sanz-González
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Red Temática de Investigación Cooperativa de Patología ocular OFTARED, Instituto de Salud Carlos III, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - J Raga-Cervera
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - J J García-Medina
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Red Temática de Investigación Cooperativa de Patología ocular OFTARED, Instituto de Salud Carlos III, Madrid, España; Departamento de Oftalmología, Hospital Universitario Morales Meseguer, y Departamento de Oftalmología, Universidad de Murcia, Murcia, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - M I López-Gálvez
- Red Temática de Investigación Cooperativa de Patología ocular OFTARED, Instituto de Salud Carlos III, Madrid, España; Departamento de Oftalmología, Hospital Clínico Universitario, Valladolid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - D Galarreta-Mira
- Red Temática de Investigación Cooperativa de Patología ocular OFTARED, Instituto de Salud Carlos III, Madrid, España; Departamento de Oftalmología, Hospital Clínico Universitario, Valladolid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - L Duarte
- Departamento de Oftalmología, Hospital Entre Douro e Vouga, Porto, Portugal; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - C Campos-Borges
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Departamento de Oftalmología, Hospital Privado da Boa Nova, Porto, Portugal; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
| | - V Zanón-Moreno
- Unidad de Investigación Oftalmológica «Santiago Grisolía»/FISABIO y Unidad de Oftalmobiología Celular y Molecular, Departamento de Cirugía, Universidad de Valencia, Valencia, España; Red Temática de Investigación Cooperativa de Patología ocular OFTARED, Instituto de Salud Carlos III, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Valencia, Valencia, España
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17
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Zhang X, Gao Y, Zhou Z, Wang J, Zhou Q, Li Q. Familial Clustering of Diabetic Retinopathy in Chongqing, China, Type 2 Diabetic Patients. Eur J Ophthalmol 2018; 20:911-8. [PMID: 20306445 DOI: 10.1177/112067211002000516] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Xuedong Zhang
- Department of Ophthalmology, The 1st Affiliated Hospital, Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing, China.
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18
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Barsegian A, Kotlyar B, Lee J, Salifu MO, McFarlane SI. Diabetic Retinopathy: Focus on Minority Populations. INTERNATIONAL JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM 2017; 3:034-45. [PMID: 29756128 PMCID: PMC5945200 DOI: 10.17352/ijcem.000027] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Diabetic retinopathy is a major cause of blindness in the United States. With rise of the epidemic of obesity and diabetes in the USA and around the globe, serious and common diabetic complications are evolving as a major public health problem, particularly among minority populations. These populations are disproportionately affected by diabetes and 2-3 times more likely to develop visually significant complications. In this highly illustrated review article, we discuss the diabetic epidemic, highlighting the biology and the pathophysiologic mechanisms of this disorder on the anatomy of the eye. We also discuss the risk factors and the implications for minority populations. For the health care providers, we provide cutting edge information and imminently relevant information to help evaluate, manage, and know when to refer their patients to a specialist in ophthalmology to quell the tide of the epidemic.
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Affiliation(s)
- Arpine Barsegian
- Department of Ophthalmology, SUNY-Downstate Medical Center and Kings County Hospital, Brooklyn, NY 11203, USA
| | - Boleslav Kotlyar
- Department of Ophthalmology, SUNY-Downstate Medical Center and Kings County Hospital, Brooklyn, NY 11203, USA
| | - Justin Lee
- Department of Medicine, SUNY-Downstate Medical Center and Kings County Hospital, Brooklyn, NY 11203, USA
| | - Moro O Salifu
- Department of Medicine, SUNY-Downstate Medical Center and Kings County Hospital, Brooklyn, NY 11203, USA
| | - Samy I McFarlane
- Department of Medicine, SUNY-Downstate Medical Center and Kings County Hospital, Brooklyn, NY 11203, USA
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19
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Abstract
PURPOSE OF REVIEW Diabetic complications affecting the kidneys, retina, nerves, and the cardiovasculature are the major causes of morbidity and mortality in diabetes. This paper aims to review the current understanding of the genetic basis of these complications, based on recent findings especially from genome-wide association studies. RECENT FINDINGS Variants in or near AFF3, RGMA-MCTP2, SP3-CDCA7, GLRA3, CNKSR3, and UMOD have reached genome-wide significance (p value <5 × 10-8) for association with diabetic kidney disease, and recently, GRB2 was reported to be associated at genome-wide significance with diabetic retinopathy. While some loci affecting cardiovascular disease in the general population have been replicated in diabetes, GLUL affects the risk of cardiovascular disease specifically in diabetic subjects. Genetic findings are emerging for diabetic complications, although the studies remain relatively small compared to those for type 1 and type 2 diabetes. In addition to pinpointing specific loci, the studies also reveal biological information on correlated traits and pathways.
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Affiliation(s)
- Emma Dahlström
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland.
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
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20
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Wang H, Cade BE, Chen H, Gleason KJ, Saxena R, Feng T, Larkin EK, Vasan RS, Lin H, Patel SR, Tracy RP, Liu Y, Gottlieb DJ, Below JE, Hanis CL, Petty LE, Sunyaev SR, Frazier-Wood AC, Rotter JI, Post W, Lin X, Redline S, Zhu X. Variants in angiopoietin-2 (ANGPT2) contribute to variation in nocturnal oxyhaemoglobin saturation level. Hum Mol Genet 2017; 25:5244-5253. [PMID: 27798093 DOI: 10.1093/hmg/ddw324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/19/2016] [Indexed: 12/30/2022] Open
Abstract
Genetic determinants of sleep-disordered breathing (SDB), a common set of disorders that contribute to significant cardiovascular and neuropsychiatric morbidity, are not clear. Overnight nocturnal oxygen saturation (SaO2) is a clinically relevant and easily measured indicator of SDB severity but its genetic contribution has never been studied. Our recent study suggests nocturnal SaO2 is heritable. We performed linkage analysis, association analysis and haplotype analysis of average nocturnal oxyhaemoglobin saturation in participants in the Cleveland Family Study (CFS), followed by gene-based association and additional tests in four independent samples. Linkage analysis identified a peak (LOD = 4.29) on chromosome 8p23. Follow-up association analysis identified two haplotypes in angiopoietin-2 (ANGPT2) that significantly contributed to the variation of SaO2 (P = 8 × 10-5) and accounted for a portion of the linkage evidence. Gene-based association analysis replicated the association of ANGPT2 and nocturnal SaO2. A rare missense SNP rs200291021 in ANGPT2 was associated with serum angiopoietin-2 level (P = 1.29 × 10-4), which was associated with SaO2 (P = 0.002). Our study provides the first evidence for the association of ANGPT2, a gene previously implicated in acute lung injury syndromes, with nocturnal SaO2, suggesting that this gene has a broad range of effects on gas exchange, including influencing oxygenation during sleep.
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Affiliation(s)
- Heming Wang
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Han Chen
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kevin J Gleason
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Richa Saxena
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Center for Human Genetic Research and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Tao Feng
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Emma K Larkin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ramachandran S Vasan
- Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA.,Framingham Heart Study, Framingham, MA
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Russell P Tracy
- Department of Pathology & Laboratory Medicine, University of Vermont, Burlington, VT, USA
| | - Yongmei Liu
- Epidemiology and Prevention Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Sleep Disorders Center, VA Boston Healthcare System, Boston, MA, USA
| | - Jennifer E Below
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Craig L Hanis
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lauren E Petty
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shamil R Sunyaev
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Wendy Post
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
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21
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Liu E, Craig JE, Burdon K. Diabetic macular oedema: clinical risk factors and emerging genetic influences. Clin Exp Optom 2017; 100:569-576. [PMID: 28556097 DOI: 10.1111/cxo.12552] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/20/2017] [Accepted: 03/02/2017] [Indexed: 12/18/2022] Open
Abstract
Diabetic macular oedema is the major cause of visual impairment in type 1 and type 2 diabetes. As type 2 diabetes becomes more prevalent worldwide, the prevalence of diabetic macular oedema is also expected to rise. Current management of diabetic macular oedema is challenging, expensive and not optimal in a subset of patients. Therefore, it is important to increase our understanding of the risk factors involved and develop preventative strategies. While clinical risk factors for diabetic macular oedema have been identified, few studies have addressed potential genetic risk factors. Epidemiology and family studies suggest genetic influences are of importance. In this review, we summarise known clinical risk factors, as well as discuss the small number of genetic studies that have been performed for diabetic macular oedema.
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Affiliation(s)
- Ebony Liu
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Kathryn Burdon
- Cancer, Immunology and Genetics, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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22
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McEwen MM, Elizondo-Pereo RA, Pasvogel AE, Meester I, Vargas-Villarreal J, González-Salazar F. A Modified Behavior Risk Factor Surveillance System to Assess Diabetes Self-management Behaviors and Diabetes Care in Monterrey Mexico: A Cross-sectional Study. Front Public Health 2017; 5:97. [PMID: 28512629 PMCID: PMC5411452 DOI: 10.3389/fpubh.2017.00097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 04/10/2017] [Indexed: 12/20/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the leading causes of death from worldwide non-communicable diseases. The prevalence of diabetes in the Mexico (MX)–United States border states exceeds the national rate in both countries. The economic burden of diabetes, due to decreased productivity, disability, and medical costs, is staggering and increases significantly when T2DM-related complications occur. The purpose of this study was to use a modified behavioral risk factor surveillance system (BRFSS) to describe the T2DM self-management behaviors, diabetes care, and health perception of a convenience sample of adults with T2DM in Monterrey, MX. This cross-sectional study design, with convenience sampling, was conducted with a convenience sample (n = 351) of adults in the metropolitan area of Monterrey, MX who self-reported a diagnosis of T2DM. Potential participants were recruited from local supermarkets. Twenty-six diabetes and health-related items were selected from the BRFSS and administered in face-to-face interviews by trained data collectors. Data analysis was conducted using descriptive statistics. The mean age was 47 years, and the mean length of time with T2DM was 12 years. The majority was taking oral medication and 34% required insulin. Daily self-monitoring of feet was performed by 56% of the participants; however, only 8.8% engaged in blood glucose self-monitoring. The mean number of health-care provider visits was 9.09 per year, and glycated hemoglobin level (HbA1c) was assessed 2.6 times per year. Finally, only 40.5% of the participants recalled having a dilated eye exam. We conclude the modified BRFSS survey administered in a face-to-face interview format is an appropriate tool for assessing engagement in T2DM self-management behaviors, diabetes care, and health perception. Extension of the use of this survey in a more rigorous design with a larger scale survey is encouraged.
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Affiliation(s)
- Marylyn Morris McEwen
- College of Nursing, University of Arizona, Tucson, AZ, USA.,Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | - Irene Meester
- Basic Sciences Department, University of Monterrey, Monterrey, Mexico
| | - Javier Vargas-Villarreal
- Laboratory of Cellular Physiology, Northeast Center of Research, Mexican Institute of Social Security, Monterrey, Mexico
| | - Francisco González-Salazar
- Basic Sciences Department, University of Monterrey, Monterrey, Mexico.,Laboratory of Cellular Physiology, Northeast Center of Research, Mexican Institute of Social Security, Monterrey, Mexico
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23
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Gonzalez-Salinas R, Garcia-Gutierrez MC, Garcia-Aguirre G, Morales-Canton V, Velez-Montoya R, Soberon-Ventura VR, Gonzalez V, Lechuga R, Garcia-Solis P, Garcia-Gutierrez DG, Garcia-Solis MV, Saenz de Viteri M, Solis-S JC. Evaluation of VEGF gene polymorphisms and proliferative diabetic retinopathy in Mexican population. Int J Ophthalmol 2017; 10:135-139. [PMID: 28149790 DOI: 10.18240/ijo.2017.01.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/11/2016] [Indexed: 12/17/2022] Open
Abstract
AIM To assess if the included vascular endothelial growth factor (VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mellitus (T2DM). METHODS A case-control study was conducted in adult individuals with T2DM associated to proliferative retinopathy or non-proliferative retinopathy from Oct. 2014 to Jun. 2015 from the Retina Department of the Asociation to Prevent Blindness in Mexico. The selected patients were adults with a diagnosis of T2DM ≥5y. All subjects had a comprehensive ocular examination and the classification of the retinopathy severity was made considering the Early Treatment Diabetic Retinopathy Study (ETDRS) standardization protocols. Genomic DNA was extracted from whole fresh blood. All samples were genotyped by qPCR for selected VEGF polymorphisms. Hardy-Weinberg equilibrium was calculated by comparing Chi-square values between the expected and the observed values for genotype counts. RESULTS In total 142 individuals were enrolled, 71 individuals with T2DM and associated proliferative retinopathy and 71 individuals with non-proliferative retinopathy. One-sided Fisher's exact test was performed for rs3025021 [OR (95% CI)=0.44(0.08-2.2); P=0.25] and rs2010963 [OR (95% CI)=0.63(0.25-1.6); P=0.23]. The minor allelic frequencies obtained were 26% for rs3025021, 10% for rs3025035 and 61% for rs2010963. The pairwise linkage disequilibrium between the three SNP was assessed, and was as follows: rs3025021 vs rs3025035: D'=1.0, r2=0.1043, P≤0.0001; rs3025021 vs rs2010963: D'=0.442, r2=0.0446, P=0.149; rs3025035 vs rs2010963: D'=0.505, r2=0.0214, P=0.142. CONCLUSION This is the first analysis involving VEGF polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that different populations have different associations for the same polymorphisms.
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Affiliation(s)
- Roberto Gonzalez-Salinas
- Biomedical Research Department, Autonomous University of Queretaro, Queretaro 76170, Mexico; Research Department, Asociation to Prevent Blindness in Mexico, Mexico City 04030, Mexico
| | | | | | | | - Raul Velez-Montoya
- Retina Department, Asociation to Prevent Blindness in Mexico, Mexico City 04030, Mexico
| | | | - Victoria Gonzalez
- Retina Department, Asociation to Prevent Blindness in Mexico, Mexico City 04030, Mexico
| | - Rodrigo Lechuga
- Retina Department, Asociation to Prevent Blindness in Mexico, Mexico City 04030, Mexico
| | - Pablo Garcia-Solis
- Biomedical Research Department, Autonomous University of Queretaro, Queretaro 76170, Mexico
| | | | | | | | - Juan C Solis-S
- Biomedical Research Department, Autonomous University of Queretaro, Queretaro 76170, Mexico
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Ting DSW, Cheung GCM, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Ophthalmol 2016; 44:260-77. [DOI: 10.1111/ceo.12696] [Citation(s) in RCA: 444] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 12/07/2015] [Accepted: 12/21/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Daniel Shu Wei Ting
- Singapore National Eye Center, Singapore Health Service (SingHealth); Singapore Singapore
- Singapore Eye Research Institute; Singapore Singapore
| | - Gemmy Chui Ming Cheung
- Singapore National Eye Center, Singapore Health Service (SingHealth); Singapore Singapore
- Singapore Eye Research Institute; Singapore Singapore
- Duke-NUS Graduate Medical School; Singapore Singapore
| | - Tien Yin Wong
- Singapore National Eye Center, Singapore Health Service (SingHealth); Singapore Singapore
- Singapore Eye Research Institute; Singapore Singapore
- Duke-NUS Graduate Medical School; Singapore Singapore
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Davoudi S, Sobrin L. Novel Genetic Actors of Diabetes-Associated Microvascular Complications: Retinopathy, Kidney Disease and Neuropathy. Rev Diabet Stud 2016; 12:243-59. [PMID: 26859656 DOI: 10.1900/rds.2015.12.243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Both type 1 and type 2 diabetes mellitus can lead to the common microvascular complications of diabetic retinopathy, kidney disease, and neuropathy. Diabetic patients do not universally develop these complications. Long duration of diabetes and poor glycemic control explain a lot of the variability in the development of microvascular complications, but not all. Genetic factors account for some of the remaining variability because of the heritability and familial clustering of these complications. There have been a large number of investigations, including linkage studies, candidate gene studies, and genome-wide association studies, all of which have sought to identify the specific variants that increase susceptibility. For retinopathy, several genome-wide association studies have been performed in small or midsize samples, but no reproducible loci across the studies have been identified. For diabetic kidney disease, genome-wide association studies in larger samples have been performed, and loci for this complication are beginning to emerge. However, validation of the existing discoveries, and further novel discoveries in larger samples is ongoing. The amount of genetic research into diabetic neuropathy has been very limited, and much is dedicated to the understanding of genetic risk factors only. Collaborations that pool samples and aim to detect phenotype classifications more precisely are promising avenues for a better explanation of the genetics of diabetic microvascular complications.
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Affiliation(s)
- Samaneh Davoudi
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
| | - Lucia Sobrin
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
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26
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Chen CF, Liou SW, Wu HH, Lin CH, Huang LS, Woung LC, Tsai CY. Regulatory SNPs Alter the Gene Expression of Diabetic Retinopathy Associated Secretary Factors. Int J Med Sci 2016; 13:717-23. [PMID: 27648002 PMCID: PMC5027191 DOI: 10.7150/ijms.16345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/30/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Diabetic retinopathy (DR) is a common microvascular complication in both type I and type II diabetes. Several previous reports indicated the serum centration of some secretary factors were highly associated with DR. Therefore, we hypothesis regulatory SNPs (rSNPs) genotype in secretary factors may alter these gene expression and lead to DR. METHODS At first, pyrosequencing were applying to screen the SNPs which present allele frequency different in DR and DNR. Then individual genotyping was processed by Taqman assays in Taiwanese DR and DNR patients. To evaluate the effect of SNP allele on transcriptional activity, we measured promoter activity using luciferase reporter constructs. RESULTS We found the frequencies of the CC, CG, and GG genotype of the rs2010963 polymorphism were 15.09%, 47.14%, and 37.74% in DR and 12.90%, 19.35%, and 67.74% in DNR, respectively (p = 0.0205). The prevalence of DR was higher (p = 0.00793) in patients with the CC or CG genotype (62.26% and 32.26% for DR and DNR, respectively) compared with the patients with the GG genotype. To evaluate the effect of rs2010963-C allele on transcriptional activity, we measured promoter activity using luciferase reporter constructs. The rs2010963-C reporter showed 1.6 to 2-fold higher luciferase activity than rs2010963-G in 3 cell lines. CONCLUSION Our data proposed rs2010963-C altered the expression level of VEGFA in different tissues. We suggested small increase but long term exposure to VEGFA may lead to DR finally.
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Affiliation(s)
- Chian-Feng Chen
- VYM Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shiow-Wen Liou
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan;; Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan;; Department of Ophthalmology, Taipei Medical University, Taipei, Taiwan;; Department of Ophthalmology, Taiwan University Hospital, Taipei, Taiwan
| | - Hsin-Han Wu
- VYM Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Hui Lin
- VYM Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Li-Shan Huang
- Department of Internal Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Lin-Chung Woung
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan;; Department of Ophthalmology, Taiwan University Hospital, Taipei, Taiwan;; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan;; Department of Medicine, National Yang-Ming University, Taipei, Taiwan;; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Yao Tsai
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan;; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. EYE AND VISION 2015. [PMID: 26605370 DOI: 10.1186/s40662-015-0026-2 10.1186/s40662-015-0026-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
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Affiliation(s)
- Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
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Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. EYE AND VISION (LONDON, ENGLAND) 2015. [PMID: 26605370 DOI: 10.1186/s40662-015-0026-2+10.1186/s40662-015-0026-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
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Affiliation(s)
- Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
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29
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Burdon KP, Fogarty RD, Shen W, Abhary S, Kaidonis G, Appukuttan B, Hewitt AW, Sharma S, Daniell M, Essex RW, Chang JH, Klebe S, Lake SR, Pal B, Jenkins A, Govindarjan G, Sundaresan P, Lamoureux EL, Ramasamy K, Pefkianaki M, Hykin PG, Petrovsky N, Brown MA, Gillies MC, Craig JE. Genome-wide association study for sight-threatening diabetic retinopathy reveals association with genetic variation near the GRB2 gene. Diabetologia 2015; 58:2288-97. [PMID: 26188370 DOI: 10.1007/s00125-015-3697-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS Diabetic retinopathy is a serious complication of diabetes mellitus and can lead to blindness. A genetic component, in addition to traditional risk factors, has been well described although strong genetic factors have not yet been identified. Here, we aimed to identify novel genetic risk factors for sight-threatening diabetic retinopathy using a genome-wide association study. METHODS Retinopathy was assessed in white Australians with type 2 diabetes mellitus. Genome-wide association analysis was conducted for comparison of cases of sight-threatening diabetic retinopathy (n = 336) with diabetic controls with no retinopathy (n = 508). Top ranking single nucleotide polymorphisms were typed in a type 2 diabetes replication cohort, a type 1 diabetes cohort and an Indian type 2 cohort. A mouse model of proliferative retinopathy was used to assess differential expression of the nearby candidate gene GRB2 by immunohistochemistry and quantitative western blot. RESULTS The top ranked variant was rs3805931 with p = 2.66 × 10(-7), but no association was found in the replication cohort. Only rs9896052 (p = 6.55 × 10(-5)) was associated with sight-threatening diabetic retinopathy in both the type 2 (p = 0.035) and the type 1 (p = 0.041) replication cohorts, as well as in the Indian cohort (p = 0.016). The study-wide meta-analysis reached genome-wide significance (p = 4.15 × 10(-8)). The GRB2 gene is located downstream of this variant and a mouse model of retinopathy showed increased GRB2 expression in the retina. CONCLUSIONS/INTERPRETATION Genetic variation near GRB2 on chromosome 17q25.1 is associated with sight-threatening diabetic retinopathy. Several genes in this region are promising candidates and in particular GRB2 is upregulated during retinal stress and neovascularisation.
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Affiliation(s)
- Kathryn P Burdon
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
- Menzies Institute for Medical Research, University of Tasmania, Private bag 23, Hobart, TAS, 7000, Australia.
| | - Rhys D Fogarty
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Weiyong Shen
- Save Sight Institute, Clinical Ophthalmology and Eye Health, The University of Sydney, Sydney, NSW, Australia
| | - Sotoodeh Abhary
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Georgia Kaidonis
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Binoy Appukuttan
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, VIC, Australia
| | - Shiwani Sharma
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Mark Daniell
- Department of Ophthalmology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Canberra, ACT, Australia
| | - John H Chang
- School of Medical Sciences, University of NSW, Sydney, NSW, Australia
- Medical Retina Service, Moorfields Eye Hospital, London, UK
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Stewart R Lake
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Bishwanath Pal
- Medical Retina Service, Moorfields Eye Hospital, London, UK
| | | | - Gowthaman Govindarjan
- Department of Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | - Periasamy Sundaresan
- Department of Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | - Ecosse L Lamoureux
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, VIC, Australia
- Department of Population Health, Singapore Eye Research Institute, Singapore, Singapore
| | - Kim Ramasamy
- Retina Clinic, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | | | - Philip G Hykin
- Medical Retina Service, Moorfields Eye Hospital, London, UK
| | - Nikolai Petrovsky
- Department of Endocrinology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Matthew A Brown
- Diamantina Institute, The University of Queensland, Translational Research Institute Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Mark C Gillies
- Save Sight Institute, Clinical Ophthalmology and Eye Health, The University of Sydney, Sydney, NSW, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
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Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. EYE AND VISION 2015; 2:17. [PMID: 26605370 PMCID: PMC4657234 DOI: 10.1186/s40662-015-0026-2] [Citation(s) in RCA: 869] [Impact Index Per Article: 96.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 09/01/2015] [Indexed: 12/15/2022]
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.
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Affiliation(s)
- Ryan Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore
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Cepeda-Nieto AC, Esquivel-Contreras MT, Duran-Iñiguez F, Salinas-Santander MA, Gallardo-Blanco HL, Esparza-González SC, Zugasti-Cruz A, Morlett-Chávez JA, Córdova-Alvelais LT. High prevalence of diabetic retinopathy and lack of association with integrin α2 gene polymorphisms in patients with type 2 diabetes from Northeastern Mexico. Exp Ther Med 2015; 10:435-444. [PMID: 26622334 PMCID: PMC4508982 DOI: 10.3892/etm.2015.2520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 04/30/2015] [Indexed: 12/16/2022] Open
Abstract
Diabetic retinopathy (DR) is one of the primary causes of blindness in the working age population and is characterized by angiogenesis in the retina. Platelets have been suggested to be involved in the pathogenesis of diabetic microvascular complications. The integrin receptor for collagen/laminin, α2β1, mediates platelet primary adhesion to subendothelial tissues, which is an essential first step in thrombus formation. The gene encoding the α2 subunit of α2β1 integrin has ≥8 polymorphisms, including a BglII/NdeI restriction fragment length polymorphism. To explore the prevalence of DR in a population from Northeastern Mexico, unrelated, hospitalized patients who had received a diagnosis of type 2 diabetes mellitus (DM2) at least 10 years previously were recruited (n=177). DR was diagnosed in a masked manner by independent ophthalmologists using fundus images captured using a non-mydriatic retinal camera. A total of 121 patients with DM2 (68%) had some degree of DR development (DR patients), and 56 patients with DM2 (32%) did not exhibit any sign of DR (No-DR patients). The results showed that after 15 years of DM2 progression, there is an increased risk of DR (P=0.0497; odds ratio, 1.993). In addition, insulin therapy and family history of DM2 were significantly associated with DR. In order to detect a possible association between DR and BglII/NdeI α2 gene polymorphisms, a comparative cross-sectional study between DR and No-DR patients was conducted. The α2 gene was genotyped by polymerase chain reaction-restriction fragment length polymorphism assay. Statistical analysis revealed no association between BglII/NdeI genotypes and the development of DR in this group of patients. In conclusion, the present data indicate a high prevalence of DR in the Mexican population and suggest that the damage in DR is due to other factors, such as the duration of the DM2, and is not linked to BglII/NdeI α2 gene polymorphisms.
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Affiliation(s)
- Ana Cecilia Cepeda-Nieto
- Research Department, Faculty of Medicine, Autonomous University of Coahuila, Saltillo, Coahuila 25000, Mexico
| | | | - Francisco Duran-Iñiguez
- Research Department, Faculty of Medicine, Autonomous University of Coahuila, Saltillo, Coahuila 25000, Mexico
| | | | - Hugo Leonid Gallardo-Blanco
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | | | - Alejandro Zugasti-Cruz
- Faculty of Chemical Sciences, Autonomous University of Coahuila, Saltillo, Coahuila 25280, Mexico
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Simó R, Hernández C. Novel approaches for treating diabetic retinopathy based on recent pathogenic evidence. Prog Retin Eye Res 2015; 48:160-80. [PMID: 25936649 DOI: 10.1016/j.preteyeres.2015.04.003] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/13/2015] [Accepted: 04/21/2015] [Indexed: 12/15/2022]
Abstract
Diabetic retinopathy remains as a leading cause of blindness in developed countries. Current treatments target late stages of DR when vision has already been significantly affected. A better understanding of the pathogenesis of DR would permit the development of more efficient preventional/interventional strategies against early stages of DR. In this article a critical review of the state of the art of this issue is provided along with a discussion of problems which have yet to be overcome. Neuroprotection as a new approach for the treatment of the early stages of DR has been particularly emphasized. The development and progression of DR is not homogeneous and, apart from blood glucose levels and blood pressure, it depends on genetic factors which remain to be elucidated. In addition, the role of the pathogenic pathways is not the same in all patients. All these factors should be taken into account in the near future when an individualized oriented treatment for DR could become feasible. The new techniques in retinal imaging acquisition, the identification of useful circulating biomarkers and the individualized analysis of biological samples could facilitate the development of early and personalized therapy in the setting of DR. Finally, it should be noted that only a coordinated action among ophthalmologists, diabetologists, basic researchers, experts in pharmaco-economics and health care providers addressed to the design of rational strategies targeting prevention and the early stages of DR will be effective in reducing the burden and improving the clinical outcome of this devastating complication of diabetes.
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Affiliation(s)
- Rafael Simó
- CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, 08035 Barcelona, Spain.
| | - Cristina Hernández
- CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, 08035 Barcelona, Spain.
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Chen YW, Wang YY, Zhao D, Yu CG, Xin Z, Cao X, Shi J, Yang GR, Yuan MX, Yang JK. High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy. PLoS One 2015; 10:e0122022. [PMID: 25822410 PMCID: PMC4379174 DOI: 10.1371/journal.pone.0122022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 02/06/2015] [Indexed: 11/30/2022] Open
Abstract
Little is known about the relationship between lower extremity peripheral arterial disease (PAD) and proliferative diabetic retinopathy (PDR) in type 2 diabetes (T2D). Here, we explored the relationship between sight-threatening PDR and PAD. We screened for diabetic retinopathy (DR) and PAD in hospitalized patients with T2D. Patients with a diabetic duration of more than 10 years, HbA1c ≥7.5%, eGFR ≥60mL/min/1.73m2 and with PDR or with no diabetic retinopathy (NDR) were eligible for this cross-sectional study. Severities of DR were graded by digital retinal photographs according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. We assessed PAD by measuring Ankle Brachial Index (ABI), Toe Brachial Index (TBI) and Doppler ultrasound. Statistical analyses were performed using SPSS 17.0 software. Of the 1544 patients, 169 patients with extreme eye (57 PDR and 112 NDR) phenotypes met the inclusion criteria. Patients with PDR had a significantly higher proportion of low ABI (≤0.99) and high ABI (≥1.3) than patients with NDR (28.1% and 15.8% vs. 14.3% and 6.2% respectively, P<0.05). PDR patients also had lower TBI than NDR patients (0.56±0.09 vs. 0.61±0.08, P<0.01). The proportion of patients with abnormal duplex ultrasound was higher in PDR than in NDR (21.1% vs. 9.8%, P<0.001). This showed that PDR associated with PAD could be defined in multiple ways: abnormal ABI (≤0.9) (OR = 3.61, 95% CI: 1.15–11.26), abnormal TBI (OR = 2.84, 95% CI: 1.19–6.64), abnormal duplex (OR = 3.28, 95% CI: 1.00–10.71), and critical limb ischemia (OR = 5.52, 95% CI: 2.14–14.26). Moreover, PDR was a stronger independent correlation factor for PAD than a diabetic duration of 10 years. In conclusion, PAD is more common in PDR than in NDR. It implies that PDR and PAD are mostly concomitant in T2D. We should focus on screening PAD in patients with PDR in clinical practice.
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Affiliation(s)
- Yi-Wen Chen
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying-Ying Wang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Dong Zhao
- Department of Endocrinology, Beijing Tongzhou District Luhe Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Cai-Guo Yu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Endocrinology, Beijing Tongzhou District Luhe Hospital, Capital Medical University, Beijing, China
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Xi Cao
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Jing Shi
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Guang-Ran Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Ming-Xia Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
- * E-mail:
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Peng D, Wang J, Zhang R, Tang S, Jiang F, Chen M, Yan J, Sun X, Wang T, Wang S, Bao Y, Hu C, Jia W. C-reactive protein genetic variant is associated with diabetic retinopathy in Chinese patients with type 2 diabetes. BMC Endocr Disord 2015; 15:8. [PMID: 25887518 PMCID: PMC4350906 DOI: 10.1186/s12902-015-0006-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 02/18/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is an important microvascular complication of diabetes with a high concordance rate in patients with diabetes. Inflammation is supposed to participate in the development of DR. This study aimed to investigate whether genetic variants of CRP are associated with DR. METHODS A total of 1,018 patients with type 2 diabetes were recruited in this study. Of these patients, 618 were diagnosed with DR, 400 were patients with diabetes for over 10 years but without DR, considered as cases and controls for DR, respectively. Four tagging SNPs (rs2808629, rs3093077, rs1130864 and rs2808634) within CRP region were genotyped for all the participants. Fundus photography was performed for diagnosis and classification for DR. RESULTS rs2808629 was significantly associated with increased susceptibility to DR (odds ratio 1.296, 95% CI 1.076-1.561, P = 0.006, empirical P = 0.029, for G allele). This association remained significant after adjustment for confounding factors (odds ratio 1.261, 95% CI 1.022-1.555, P = 0.030). CONCLUSIONS In this study, we found CRP rs2808629 was associated with DR in the Chinese patients with type 2 diabetes.
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Affiliation(s)
- Danfeng Peng
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Jie Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Rong Zhang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Shanshan Tang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Feng Jiang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Miao Chen
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Jing Yan
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Xue Sun
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Tao Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Shiyun Wang
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Yuqian Bao
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Cheng Hu
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Weiping Jia
- Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
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Liu NJ, Wu HH, Li YL, Yang Z, Tao XM, Du YP, Wang XC, Lu B, Zhang ZY, Hu RM, Wen J. An analysis of the association between a polymorphism of KCNJ11 and diabetic retinopathy in a Chinese Han population. Eur J Med Res 2015; 20:3. [PMID: 25573672 PMCID: PMC4301311 DOI: 10.1186/s40001-014-0075-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/08/2014] [Indexed: 12/26/2022] Open
Abstract
Background Genome-wide association studies (GWAS) have reported that the polymorphism rs5219 of the potassium inwardly rectifying channel, subfamily J, member 11 (KCNJ11) is associated with type 2 diabetes mellitus (T2DM). Given that diabetic retinopathy (DR) is one of the most common microvascular complications of T2DM, GWAS have identified a number of potential susceptibility genes for DR. However, only a fraction of them have been replicated in different studies and show consistent genetic associations with the occurrence of DR. The aim of the present study was to investigate whether common variants of KCNJ11 confer DR in a cohort of the Chinese Han population. Methods A case–control study of 580 T2DM patients, including 105 T2DM with DR and 475 T2DM without DR was performed. A single nucleotide polymorphism (SNP) of KCNJ11 (rs5219) was genotyped, and its association with DR was explored using a dominant genetic model. Genotyping was performed by iPLEX technology. Univariate and multivariate logistic regression (MLR) analysis controlling for confounders was conducted to evaluate the association between rs5219 and DR. Results The A allele frequency of rs5219 was significantly higher in DR patients than that in the patients without DR (49.01% versus 38.68%, P <0.05). We found the minor A allele could increase the risk to develop DR (ORint = 1.58, 95% CI: 1.139 to 2.192 for allele and P = 0.006, ORint = 1.607, 95% CI: 1.267 to 2.038 for genotype and P <0.001) in the Chinese Han population. Conclusions Our findings provided evidence that KCNJ11 was associated with DR in Chinese Han patients with T2DM.
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Affiliation(s)
- Nai-Jia Liu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Hui-Hui Wu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Yan-Liang Li
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Zhen Yang
- Department of Endocrinology and Metabolism, Xin Hua Hospital, Shanghai Jiao Tong University, NO. 1665 Kongjiang Road, Yangpu District, Shanghai, 200020, China.
| | - Xiao-Ming Tao
- Department of Endocrinology and Metabolism, Hua Dong Hospital, Fudan University, NO. 221 Yan'an West Road, Jing'an District, Shanghai, 200040, China.
| | - Yan-Ping Du
- Department of Endocrinology and Metabolism, Hua Dong Hospital, Fudan University, NO. 221 Yan'an West Road, Jing'an District, Shanghai, 200040, China.
| | - Xuan-Chun Wang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Bin Lu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Zhao-Yun Zhang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Ren-Ming Hu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
| | - Jie Wen
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, NO. 12 Wulumuqi Mid Road, Building 0#, Jing'an District, Shanghai, 200040, China.
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Awata T, Yamashita H, Kurihara S, Morita-Ohkubo T, Miyashita Y, Katayama S, Mori K, Yoneya S, Kohda M, Okazaki Y, Maruyama T, Shimada A, Yasuda K, Nishida N, Tokunaga K, Koike A. A genome-wide association study for diabetic retinopathy in a Japanese population: potential association with a long intergenic non-coding RNA. PLoS One 2014; 9:e111715. [PMID: 25364816 PMCID: PMC4218806 DOI: 10.1371/journal.pone.0111715] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/30/2014] [Indexed: 12/31/2022] Open
Abstract
Elucidation of the genetic susceptibility factors for diabetic retinopathy (DR) is important to gain insight into the pathogenesis of DR, and may help to define genetic risk factors for this condition. In the present study, we conducted a three-stage genome-wide association study (GWAS) to identify DR susceptibility loci in Japanese patients, which comprised a total of 837 type 2 diabetes patients with DR (cases) and 1,149 without DR (controls). From the stage 1 genome-wide scan of 446 subjects (205 cases and 241 controls) on 614,216 SNPs, 249 SNPs were selected for the stage 2 replication in 623 subjects (335 cases and 288 controls). Eight SNPs were further followed up in a stage 3 study of 297 cases and 620 controls. The top signal from the present association analysis was rs9362054 in an intron of RP1-90L14.1 showing borderline genome-wide significance (Pmet = 1.4×10−7, meta-analysis of stage 1 and stage 2, allele model). RP1-90L14.1 is a long intergenic non-coding RNA (lincRNA) adjacent to KIAA1009/QN1/CEP162 gene; CEP162 plays a critical role in ciliary transition zone formation before ciliogenesis. The present study raises the possibility that the dysregulation of ciliary-associated genes plays a role in susceptibility to DR.
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Affiliation(s)
- Takuya Awata
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
- * E-mail:
| | - Hisakuni Yamashita
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Susumu Kurihara
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoko Morita-Ohkubo
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yumi Miyashita
- Division of RI Laboratory, Biomedical Research Center, Saitama Medical University, Saitama, Japan
| | - Shigehiro Katayama
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Keisuke Mori
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Faculty of Medicine, Saitama, Japan
| | - Shin Yoneya
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Faculty of Medicine, Saitama, Japan
| | - Masakazu Kohda
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yasushi Okazaki
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Taro Maruyama
- Department of Internal Medicine, Saitama Social Insurance Hospital, Saitama, Japan
| | - Akira Shimada
- Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan
| | - Kazuki Yasuda
- Department of Metabolic Disorder, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nao Nishida
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Asako Koike
- Central Research Laboratory, Hitachi Ltd, Tokyo, Japan
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Abstract
Diabetic retinopathy (DR) is a polygenic disorder. Twin studies and familial aggregation studies have documented clear familial clustering. Heritability has been estimated to be as high as 27 % for any DR and 52 % for proliferative diabetic retinopathy (PDR), an advanced form of the disease. Linkage analyses, candidate gene association studies and genome-wide association studies (GWAS) performed to date have not identified any widely reproducible risk loci for DR. Combined analysis of the data from multiple GWAS is emerging as an important next step to explain the unaccounted heritability. Key factors to future discovery of the genetic underpinnings of DR are precise DR ascertainment, a focus on the more heritable disease forms such as PDR, stringent selection of control participants with regards to duration of diabetes, and methods that allow combination of existing datasets from different ethnicities to achieve sufficient sample sizes to detect variants with modest effect sizes.
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Affiliation(s)
- Heeyoon Cho
- Hanyang University College of Medicine, Department of Ophthalmology, 222 Wangsimni-ro, Seongdong-gu, Seoul, 133-791, Korea (Republic of Korea), Tel. 82-31-560-2353, Fax 82-31-564-9479
- Massachusetts Eye and Ear Infirmary, 243 Charles Street, 12 floor, Boston, MA 02114, Tel. 617-573-4279, Fax 617-573-3011
| | - Lucia Sobrin
- Massachusetts Eye and Ear Infirmary, 243 Charles Street, 12 floor, Boston, MA 02114, Tel. 617-573-4279, Fax 617-573-3011
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Chen M, Lin WR, Lu CH, Chen CC, Huang YC, Liao WL, Tsai FJ. Chimerin 2 genetic polymorphisms are associated with non-proliferative diabetic retinopathy in Taiwanese type 2 diabetic patients. J Diabetes Complications 2014; 28:460-3. [PMID: 24854763 DOI: 10.1016/j.jdiacomp.2014.04.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 04/01/2014] [Accepted: 04/11/2014] [Indexed: 12/12/2022]
Abstract
AIM To investigate whether chimerin 2 (CHN2) genetic polymorphisms were associated with the susceptibility to diabetic retinopathy (DR) in Taiwanese individuals with type 2 diabetes. METHODS This case-control study comprised of 171 individuals with DR and 548 without DR. Four rs39059, rs2023908, rs1002630 and rs1362363 polymorphism of CHN2 were genotyped for each subjects. All subjects underwent a complete ophthalmologic examination, and basic information (age, gender, age at diagnosis of diabetes, and ocular history of the patient) was record. Several clinical parameters (systolic and diastolic blood pressure, waist and hip circumferences, body mass index levels, fasting glucose and HbA1c) were measured. RESULTS Logistic regressions were used to analyze odds ratios between SNPs and DR after controlling for gender, systolic blood pressure, waist and hip ratio, duration of diabetes, serum HbA1c levels and nephropathy classification. A protective effect of rs1002630 (GA+AA) and rs1362363 (AG+GG) [odds ratio (OR) (95% confidence interval)=0.45 (0.22-0.88), 0.66 (0.44-0.99), respectively) was observed. Furthermore, the protective effect of rs1002630 was observed when compared subjects with non-proliferative DR with subjects without DR [OR=0.25 (95%C.I. = 0.09-0.73)]. CONCLUSIONS This study showed that the rs1002630 of CHN2 were associated with DR risk and non-proliferative DR risk in Taiwanese individuals with type 2 diabetes. Variations at this locus may contribute to the pathogenesis of DR.
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Affiliation(s)
- Marcelo Chen
- Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; School of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Wun-Rong Lin
- Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chieh-Hsiang Lu
- Division of Endocrinology and Metabolism of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chuen Huang
- School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Ling Liao
- Center for Personalized Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrate Medicine, School of Chinese Medicine, China Medical University, Taichung, Taiwan.
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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Abstract
Multiple studies have shown that genetic factors may play an important role in determining an individual's risk for the development of diabetic retinopathy (DR) and progression to proliferative DR. However, consistent and definitive genetic associations with DR across broad populations have been not been established. Numerous genes have been studied for their association with DR and the results of these investigations have most specifically pointed to three specific genes that are likely involved in DR development and progression. The gene coding for vascular endothelial growth factor, aldose reductase, and the receptor for advanced glycation end products have been extensively evaluated, and specific polymorphisms of these genes have been suggested to potentially increase the risk of DR development. In this paper, we have reviewed the published literature on the genetics of DR and the potential implications for DR development and progression.
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Affiliation(s)
- Ahmed F Omar
- Joslin Diabetes Center, Beetham Eye Institute , Boston, Massachusetts , USA and
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Wang H, Cheng JW, Zhu LS, Wei RL, Cai JP, Li Y, Ma XY. Meta-analysis of association between the -2578C/A polymorphism of the vascular endothelial growth factor and retinopathy in type 2 diabetes in Asians and Caucasians. Ophthalmic Res 2014; 52:1-8. [PMID: 24751925 DOI: 10.1159/000357110] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Vascular endothelial growth factor (VEGF) has been shown to play an important role in the development and progress of diabetic retinopathy (DR). A number of case-control studies focused on the association between VEGF -2578C/A and risk for DR. But the results were not always consistent, so we performed a meta-analysis to evaluate the precise association between this variant and risk for DR. METHODS All publications on the association between VEGF -2578C/A polymorphism and DR were searched in the following electronic databases: PubMed, Embase, the Cochrane Library and Chinese Biomedical Literature Database, with the last report up to January 2013. This meta-analysis was assessed by Review Manager 5.1. RESULTS A total of 6 studies were involved in this meta-analysis, including 835 cases and 867 controls. Overall, we found a significant association between this polymorphism and DR (A vs. C: OR=1.49, 95% CI=1.26-1.77, p<0.00001; AA vs. CA+CC: OR=1.26, 95% CI=0.94-1.68, p=0.12; AA+CA vs. CC: OR=1.56, 95% CI=1.27-1.91, p<0.00001; AA vs. CC: OR=1.67, 95% CI=1.20-2.32, p=0.003; CA vs. CC: OR=1.51, 95% CI=1.21-1.87, p=0.0002), but we did not find any significant association in Caucasians in subgroup analysis. The results were not materially altered after the studies which did not fulfill the Hardy-Weinberg equilibrium were excluded. CONCLUSION Our meta-analysis supports the association between the VEGF -2578C/A polymorphism and DR, but not in the Caucasian population.
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Affiliation(s)
- Hao Wang
- Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
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Kuo JZ, Wong TY, Rotter JI. Challenges in elucidating the genetics of diabetic retinopathy. JAMA Ophthalmol 2014; 132:96-107. [PMID: 24201651 DOI: 10.1001/jamaophthalmol.2013.5024] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE In the past decade, significant progress in genomic medicine and technologic developments has revolutionized our approach to common complex disorders in many areas of medicine, including ophthalmology. A disorder that still needs major genetic progress is diabetic retinopathy (DR), one of the leading causes of blindness in adults. OBJECTIVE To perform a literature review, present the current findings, and highlight some key challenges in DR genetics. DESIGN, SETTING, AND PARTICIPANTS We performed a thorough literature review of the genetic factors for DR, including heritability scores, twin studies, family studies, candidate gene studies, linkage studies, and genome-wide association studies (GWASs). MAIN OUTCOME MEASURES Environmental and genetic factors for DR. RESULTS Although there is clear demonstration of a genetic contribution in the development and progression of DR, the identification of susceptibility loci through candidate gene approaches, linkage studies, and GWASs is still in its infancy. The greatest obstacles remain a lack of power because of small sample size of available studies and a lack of phenotype standardization. CONCLUSIONS AND RELEVANCE The field of DR genetics is still in its infancy and is a challenge because of the complexity of the disease. This review outlines some strategies and lessons for future investigation to improve our understanding of this complex genetic disorder.
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Affiliation(s)
- Jane Z Kuo
- Medical Genetics Institute and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California2Department of Ophthalmology, University of California San Diego, La Jolla3Department of Ophthalmology, Chang Gung Memorial Hospital and
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore5Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jerome I Rotter
- Medical Genetics Institute and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California6Institute for Translational Genomics and Population Sciences, Los Angeles Bio Medical Research Institute, Harbor-UCLA Medical Center, To
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Simó-Servat O, Hernández C, Simó R. Genetics in diabetic retinopathy: current concepts and new insights. Curr Genomics 2014; 14:289-99. [PMID: 24403848 PMCID: PMC3763680 DOI: 10.2174/13892029113149990008] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/25/2013] [Accepted: 06/25/2013] [Indexed: 01/05/2023] Open
Abstract
There is emerging evidence which indicates the essential role of genetic factors in the development of diabetic retinopathy (DR). In this regard it should be highlighted that genetic factors account for 25-50% of the risk of developing DR. Therefore, the use of genetic analysis to identify those diabetic patients most prone to developing DR might be useful in designing a more individualized treatment. In this regard, there are three main research strategies: candidate gene studies, linkage studies and Genome-Wide Association Studies (GWAS). In the candidate gene approach, several genes encoding proteins closely related to DR development have been analyzed. The linkage studies analyze shared alleles among family members with DR under the assumption that these predispose to a more aggressive development of DR. Finally, Genome-Wide Association Studies (GWAS) are a new tool involving a massive evaluation of single nucleotide polymorphisms (SNP) in large samples. In this review the available information using these three methodologies is critically analyzed. A genetic approach in order to identify new candidates in the pathogenesis of DR would permit us to design more targeted therapeutic strategies in order to decrease this devastating complication of diabetes. Basic researchers, ophthalmologists, diabetologists and geneticists should work together in order to gain new insights into this issue.
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Affiliation(s)
- Olga Simó-Servat
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; ; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Spain
| | - Rafael Simó
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; ; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Spain
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El-Bab MF, Zaki NS, Mojaddidi MA, Al-Barry M, El-Beshbishy HA. Diabetic retinopathy is associated with oxidative stress and mitigation of gene expression of antioxidant enzymes. Int J Gen Med 2013; 6:799-806. [PMID: 24092995 PMCID: PMC3787894 DOI: 10.2147/ijgm.s40665] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Type 2 diabetes is a metabolic disease associated with serious complications, including diabetic retinopathy (DR). The authors' main aim was to investigate biochemical parameters and the oxidative stress associated with the type 2 DR patients and to study gene expression of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) among patients with DR [DR(+)] compared with a control nondiabetic group. In all, 67 patients with DR included in this study were diabetic for more than 10 years. Among them, 22 patients were DR(+), and 45 patients did not have DR [DR(-)]. The subjects' age range was 14 years to 80 years old with diabetes duration range between 2 and 45 years. Body mass index (BMI) was 31.43 ± 5.94 and 32.33 ± 6.54, systolic blood pressure was 117.15 ± 18.16 mmHg and 126.15 ± 20.26 mmHg, diastolic blood pressure was 81.11 ± 10.55 mmHg and 82.77 ± 10.85 mmHg, HbA1c was 7.2 ± 1.1 and 8.19 ± 1.95, serum total cholesterol was 6.61 ± 1.11 and 4.11 ± 0.31, serum triglycerides were 3.52 ± 0.89 and 3.42 ± 0.79, serum low-density lipoprotein (LDL) was 2.12 ± 0.10 and 2.42 ± 0.15, high-density lipoprotein (HDL) was 2.66 ± 0.30 and 2.55 ± 0.21, SOD was 3.12 ± 0.87 and 1.53 ± 0.14, GPx was 11.14 ± 2.21 and 8.2 ± 1.84, CAT was 26.43 ± 3.34 and 9.60 ± 2.14, for DR(-) and DR(+) patients, respectively. SOD, GPx and CAT polymerase chain reaction (PCR) products of the DR(+) patients revealed the diminished expression of CAT gene followed by GPx and SOD genes. All were significant compared with the normal controls, P < 0.05. Linear regression analysis revealed a strong significant positive correlation between the retinopathy grade and the diastolic blood pressure, diabetes duration, hemoglobin A1c (HA1c)%, and fasting blood glucose (P < 0.001). A marginally significant positive correlation between the retinopathy grade and LDL-cholesterol was observed (P < 0.05), and a significant negative correlation between the retinopathy grade and total cholesterol was observed (P < 0.05). Poor glycemic control and alteration in mRNA gene expression of antioxidant enzymes are strongly associated with development of DR and the regular screening is mandatory for early detection and treatment.
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Affiliation(s)
- Mohamed Fath El-Bab
- Department of Physiology, Taibah University, Almadinah, Kingdom of Saudi Arabia ; Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Petrovič D. Candidate genes for proliferative diabetic retinopathy. BIOMED RESEARCH INTERNATIONAL 2013; 2013:540416. [PMID: 24066292 PMCID: PMC3771247 DOI: 10.1155/2013/540416] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 07/29/2013] [Indexed: 12/21/2022]
Abstract
Several candidate genes have been so far implicated in the pathogenesis of proliferative diabetic retinopathy (PDR) in subjects with type 2 diabetes. Since the principal pathogenetic mechanisms for diabetic retinopathy (DR) and PDR are different, the main pathogenetic mechanism in DR is increased vascular permeability, whereas in PDR the crucial pathogenetic mechanisms are fibrosis and neoangiogenesis. Due to that fact, different candidate genes are expected to be involved in the development of either DR or PDR. None of the candidate genes, however, can be fully and solely responsible for the development of PDR and for DR progression into PDR. Epigenetic mechanisms are expected to be involved in the pathogenesis of PDR as well. Gene polymorphisms responsible for PDR and epigenetic mechanisms responsible for PDR are reviewed in this paper.
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Affiliation(s)
- Daniel Petrovič
- Institute of Histology and Embryology, Medical Faculty, University Ljubljana, Korytkova 2, 1105 Ljubljana, Slovenia
- Zavod Srce, Dunajska 106, 1000 Ljubljana, Slovenia
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Sheu WHH, Kuo JZ, Lee IT, Hung YJ, Lee WJ, Tsai HY, Wang JS, Goodarzi MO, Klein R, Klein BEK, Ipp E, Lin SY, Guo X, Hsieh CH, Taylor KD, Fu CP, Rotter JI, Chen YDI. Genome-wide association study in a Chinese population with diabetic retinopathy. Hum Mol Genet 2013; 22:3165-73. [PMID: 23562823 DOI: 10.1093/hmg/ddt161] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Diabetic retinopathy (DR) is a leading cause of preventable blindness in adults. To identify genetic contributions in DR, we studied 2071 type 2 diabetics. We first conducted a genome-wide association study of 1007 individuals, comparing 570 subjects with ≥8 years duration without DR (controls) with 437 PDR (cases) in the Chinese discovery cohort. Cases and controls were similar for HbA1c, diabetes duration and body mass index. Association analysis with imputed data identified three novel loci: TBC1D4-COMMD6-UCHL3 (rs9565164, P = 1.3 × 10(-7)), LRP2-BBS5 (rs1399634, P = 2.0 × 10(-6)) and ARL4C-SH3BP4 (rs2380261, P = 2.1 × 10(-6)). Analysis of an independent cohort of 585 Hispanics diabetics with or without DR though did not confirm these signals. These genes are still of particular interest because they are involved in insulin regulation, inflammation, lipid signaling and apoptosis pathways, all of which are possibly involved with DR. Our finding nominates possible novel loci as potential DR susceptibility genes in the Chinese that are independent of the level of HbA1c and duration of diabetes and may provide insight into the pathophysiology of DR.
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Affiliation(s)
- Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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Qiu M, Xiong W, Liao H, Li F. VEGF -634G>C polymorphism and diabetic retinopathy risk: a meta-analysis. Gene 2013; 518:310-5. [PMID: 23353010 DOI: 10.1016/j.gene.2013.01.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 01/09/2013] [Accepted: 01/11/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF), a multifunctional cytokine that promotes angiogenesis and is a potent mediator of microvascular permeability, which is critical for the development of diabetic retinopathy (DR). It has demonstrated that VEGF -634G>C (rs2010963) polymorphism alters the transcriptional activity of the gene. However, studies on the association between VEGF -634G>C polymorphism and DR in type 2 diabetes have reported conflicting results. Thus, the aim of the present study was to investigate whether VEGF -634G>C polymorphism is associated with the risk of DR in type 2 diabetes. METHODS A systematic search of electronic databases (PubMed, Embase and Web of Science) and reference lists of relevant articles was carried out until September 15, 2012. The pooled odds ratios (ORs) and their corresponding 95% confidence interval (CI) were calculated by a fixed effect model. RESULTS A total of 1525 DR cases and 1422 diabetic without retinopathy (DWR) controls in 9 independent studies were included in the meta-analysis. A significant relationship between VEGF -634G>C polymorphism and DR was found in an allelic genetic model (OR: 1.13, 95% CI: 1.01 to 1.25, P=0.03) and a recessive genetic model (OR: 1.26, 95% CI: 1.02 to 1.55, P=0.03). CONCLUSION Our research confirmed the association between the VEGF -634G>C polymorphism and DR in subjects with type 2 diabetes. Well-designed studies with larger sample size and more ethnic groups are required to further validate the results.
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Affiliation(s)
- Min Qiu
- Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1095 Jiefang Ave, Wuhan 430030, People's Republic of China
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Zhang T, Pang C, Li N, Zhou E, Zhao K. Plasminogen activator inhibitor-1 4G/5G polymorphism and retinopathy risk in type 2 diabetes: a meta-analysis. BMC Med 2013; 11:1. [PMID: 23281898 PMCID: PMC3565939 DOI: 10.1186/1741-7015-11-1] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 01/02/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Mounting evidence has suggested that plasminogen activator inhibitor-1 (PAI-1) is a candidate for increased risk of diabetic retinopathy. Studies have reported that insertion/deletion polymorphism in the PAI-1 gene may influence the risk of this disease. To comprehensively address this issue, we performed a meta-analysis to evaluate the association of PAI-1 4G/5G polymorphism with diabetic retinopathy in type 2 diabetes. METHODS Data were retrieved in a systematic manner and analyzed using Review Manager and STATA Statistical Software. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of associations. RESULTS Nine studies with 1, 217 cases and 1, 459 controls were included. Allelic and genotypic comparisons between cases and controls were evaluated. Overall analysis suggests a marginal association of the 4G/5G polymorphism with diabetic retinopathy (for 4G versus 5G: OR 1.13, 95%CI 1.01 to 1.26; for 4G/4G versus 5G/5G: OR 1.30, 95%CI 1.04 to 1.64; for 4G/4G versus 5G/5G + 4G/5G: OR 1.26, 95%CI 1.05 to 1.52). In subgroup analysis by ethnicity, we found an association among the Caucasian population (for 4G versus 5G: OR 1.14, 95% CI 1.00 to 1.30; for 4G/4G versus 5G/5G: OR 1.33, 95%CI 1.02 to 1.74; for 4G/4G versus 5G/5G + 4G/5G: OR 1.41, 95%CI 1.13 to 1.77). When stratified by the average duration of diabetes, patients with diabetes histories longer than 10 years have an elevated susceptibility to diabetic retinopathy than those with shorter histories (for 4G/4G versus 5G/5G: OR 1.47, 95%CI 1.08 to 2.00). We also detected a higher risk in hospital-based studies (for 4G/4G versus 5G/5G+4G/5G: OR 1.27, 95%CI 1.02 to 1.57). CONCLUSIONS The present meta-analysis suggested that 4G/5G polymorphism in the PAI-1 gene potentially increased the risk of diabetic retinopathy in type 2 diabetes and showed a discrepancy in different ethnicities. A higher susceptibility in patients with longer duration of diabetes (more than 10 years) indicated a gene-environment interaction in determining the risk of diabetic retinopathy.
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Affiliation(s)
- Tengyue Zhang
- Tianjin Medical University, 22 Qixiangtai Road, Tianjin, 300020, PR China
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Plasma plasminogen activator inhibitor-1 is associated with end-stage proliferative diabetic retinopathy in the Northern Chinese Han population. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:350852. [PMID: 23304115 PMCID: PMC3518968 DOI: 10.1155/2012/350852] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/02/2012] [Accepted: 10/09/2012] [Indexed: 01/02/2023]
Abstract
Objective. To identify predictors of end-stage proliferative diabetic retinopathy (PDR) in a cohort of individuals with type 2 diabetes mellitus (T2DM) from the Northern Chinese Han population. Methods. We investigated characteristics of 153 consecutive diabetic patients with end-stage PDR (62 males, 91 females), 123 consecutive PDR patients without end-stage PDR (48 males, 75 females), and 151 normal subjects (63 males, 88 females). Only one eye of each patient or healthy subject was included in this study. Univariate logistic regression models and multivariate logistic regression models were constructed to evaluate the predictors of end-stage PDR. Results. In univariate analysis, systolic blood pressure, diastolic blood pressure, duration of diabetes, family history of T2DM, and plasminogen activator inhibitor-1 (PAI-1) were significently associated with end-stage PDR. After multivariate analysis, family history of T2DM, plasma PAI-1 levels, smoking, and duration of diabetes were four positive predictors associated with end-stage PDR. Conclusions. Higher plasma levels of PAI-1 were associated with end-stage PDR in the Northern Chinese Han population with T2DM.
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Liang S, Pan M, Hu N, Wu YY, Chen H, Zhu JH, Guan HJ, Sang AM. Association of angiotensin-converting enzyme gene 2350 G/A polymorphism with diabetic retinopathy in Chinese Han population. Mol Biol Rep 2012; 40:463-8. [PMID: 23065222 DOI: 10.1007/s11033-012-2081-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
The angiotensin-converting enzyme (ACE) gene is one of the most studied candidate genes related to diabetic retinopathy (DR). ACE 2350 G/A polymorphism (rs4343) is known among the polymorphisms of this gene to have the most significant effect on plasma ACE concentrations. The aim of the present study was to investigate the relationship between 2350 G/A polymorphism of ACE gene and the susceptibility of DR in Chinese Han population. A case-control study for 145 type 2 diabetes mellitus (DM) patients, including 63 type 2 DM without DR (NDR) and 82 type 2 DM with DR (DR), and 90 subjects of age, gender matched normal controls (NC group) was performed. ACE 2350 G/A genotypes were identified by polymerase chain reaction and restriction digestion in all study participants. The distribution of the ACE 2350 G/A genotypes (GG, GA, and AA) was 35.56, 45.55, and 18.89 % in the NC group, 28.57, 46.03, and 25.40 % in the NDR group, and 15.85, 46.34, and 37.81 % in the DR group, respectively. There were no significant differences in either genotype frequency distribution (P = 0.5266) or allele frequency distribution (P = 0.2425) between the NC group and NDR group. However, the distribution of genotype frequency (P = 0.0026) and allele frequency (P = 0.0003) in the DR group showed a significant difference when compared to that of NC group (P = 0.0075). Moreover, there was statistical difference in allele frequency distribution (P = 0.0328) between the DR group and the NDR group. No statistical differences were observed between ACE 2350 G/A polymorphism and the diabetes duration or types of DR. Results obtained in this study indicate that ACE 2350 G/A polymorphism is associated with DR in Han Chinese patients with type 2 DM.
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Affiliation(s)
- Shu Liang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong 226001, People's Republic of China
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