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Chen CH, Wang YH, Tsai SF, Yu TM, Chen SY, Tsai FJ. Antizyme inhibitor 1 genetic polymorphisms associated with diabetic patients validated in the livers of diabetic mice. Exp Ther Med 2019; 18:3139-3146. [PMID: 31572554 DOI: 10.3892/etm.2019.7919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/06/2019] [Indexed: 11/05/2022] Open
Abstract
Diabetes mellitus (DM) is a complex disease caused by absolute or relative insulin deficiency. The C57BLKsJ-db/db mouse model is a useful animal model for studying type 2 DM (T2DM). The present study investigated the association between an antizyme inhibitor 1 (AZIN1) gene polymorphism (rs1062048) and T2DM susceptibility in 2,270 Taiwanese individuals (570 patients with T2DM and 1,700 controls). Additionally, the present study investigated AZIN1 gene and protein expression in the liver tissues of mice in three age groups (4, 16 and 32 weeks) through reverse transcription-quantitative PCR, western blotting and immunohistochemistry. The data indicated that the genotype frequency distribution of the rs1062048 single-nucleotide polymorphism differed significantly between the patients with T2DM and controls (P<0.05). Furthermore, gene and protein expression levels of AZIN1 were significantly lower in early stage and late stage T2DM mouse liver samples than in control samples. Overall, the data suggested that AZIN1 expression is involved in T2DM development.
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Affiliation(s)
- Cheng-Hsu Chen
- Department of Medical Research, Division of Basic Medical Sciences, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C.,Department of Internal Medicine, Division of Nephrology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C.,Department of Life Science, Tunghai University, Taichung 40705, Taiwan, R.O.C.,School of Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C
| | - Yeh-Han Wang
- Department of Anatomical Pathology, Taipei Institute of Pathology, School of Medicine, National Yang-Ming University, 11221 Taipei, Taiwan, R.O.C
| | - Shang-Feng Tsai
- Department of Internal Medicine, Division of Nephrology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C.,Department of Life Science, Tunghai University, Taichung 40705, Taiwan, R.O.C.,Department of Internal Medicine, School of Medicine, National Yang-Ming University, 11221 Taipei, Taiwan, R.O.C
| | - Tung-Min Yu
- Department of Internal Medicine, Division of Nephrology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C.,School of Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C
| | - Shih-Yin Chen
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C.,Genetics Center, Medical Research, China Medical University Hospital, Taichung 40447, Taiwan, R.O.C
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C.,Genetics Center, Medical Research, China Medical University Hospital, Taichung 40447, Taiwan, R.O.C.,Department of Medical Genetics, China Medical University Hospital, Taichung 40447, Taiwan, R.O.C
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Al-Sinani S, Al-Shafaee M, Al-Mamari A, Woodhouse N, Al-Shafie O, Hassan M, Al-Yahyaee S, Albarwani S, Jaju D, Al-Hashmi K, Al-Abri M, Rizvi S, Bayoumi R. Familial Clustering of Type 2 Diabetes among Omanis. Oman Med J 2014; 29:51-4. [PMID: 24498483 PMCID: PMC3910414 DOI: 10.5001/omj.2014.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 11/30/2013] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The aim of this study was to screen Omani individuals for the familial aggregation of type 2 diabetes mellitus. METHODS A random cohort of 1182 Omani individuals visiting the Family Medicine Clinic at Sultan Qaboos University Hospital (SQUH), Muscat, Oman, for regular medical checkup, aged ≥40 years, were sampled. Patients were categorized into three groups: (1) individuals who claim not to have diabetes and had no family history of diabetes; (2) individuals who claim not to have diabetes but had family history of diabetes; (3) individuals with diabetes. Only 16% of these Omani individuals had no diabetes and no family history of diabetes. Another separate random cohort of 234 Omani type 2 diabetes mellitus patients, from the Diabetes Clinic at SQUH, were interviewed and questioned about their family history of type 2 diabetes mellitus. RESULTS Ninety five percent of the patients had a family history of diabetes. Eighty percent had first degree relatives with diabetes and 46% had second degree relatives with diabetes. At least one parent with diabetes was reported among 55% of these diabetics, while maternal diabetes (55%) was found to be higher than paternal diabetes (47%). However, only 15% had both parents with diabetes. Furthermore, almost half of the 234 diabetics were having at least one of the following relatives with diabetes: brother, sister, aunt or an uncle. CONCLUSION The findings of this study confirm familial aggregation of diabetes among the Omani population. Compared to other populations, familial aggregation of type 2 diabetes mellitus among Omanis is relatively very high, and is perhaps due to the very high degree of consanguinity among Omanis. Since almost everyone seems to have a genetic predisposition to diabetes, the dramatic lifestyle changes over the past 25 years, could tip the population into an epidemic of type 2 diabetes mellitus.
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Affiliation(s)
- Sawsan Al-Sinani
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammed Al-Shafaee
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Ali Al-Mamari
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Nicholas Woodhouse
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Omaima Al-Shafie
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammed Hassan
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Said Al-Yahyaee
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Sulayma Albarwani
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Deepali Jaju
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Khamis Al-Hashmi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammed Al-Abri
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Syed Rizvi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Riad Bayoumi
- Department of Biochemistry, College of Medicine & Health Sciences, Sultan Qaboos University P.O. Box-35, Postal Code 123, Muscat, Sultanate of Oman
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Bener A, Yousafzai MT, Al-Hamaq AOAA, Mohammad AG, DeFronzo RA. Parental transmission of type 2 diabetes mellitus in a highly endogamous population. World J Diabetes 2013; 4:40-46. [PMID: 23599872 PMCID: PMC3629295 DOI: 10.4239/wjd.v4.i2.40] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 03/15/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the parental transmission of diabetes mellitus (DM) and evaluate its influence on the clinical characteristics.
METHODS: This was a cross sectional study. The survey was carried out in urban and semi-urban primary health care centers. Of the 2400 registered with diagnosed diabetes, 1980 agreed and gave their consent to take part in this study, thus giving a response rate of 82.5%. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. DM was defined according to the World Health Organization expert group. A trained nurse performed physical examinations and measurements.
RESULTS: Of the study population, 72.9% reported a family history of DM. Family history of DM was significantly higher in females (54.2%; P = 0.04) and in the age group below 30 years (24%; P < 0.001). The prevalence of diabetes was higher among patients with a diabetic mother (25.4% vs 22.1%) and maternal aunts/uncles (31.2% vs 22.2%) compared to patients with a diabetic father and paternal aunts/uncles. Family history of DM was higher in patients of consanguineous parents (38.5%) than those of non-consanguineous parents (30.2%). The development of type 2 diabetes mellitus (T2DM) complications was higher in patients with either a paternal or maternal history of DM than in those without. No significant difference was observed in the metabolic characteristics of patients with/without family history of DM except for hypertension. Complications were higher in diabetic patients with a family history of DM.
CONCLUSION: The present study found a significant maternal effect in transmission of T2DM. Family history is associated with the increased incidence of diabetes.
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Levinger I, Selig S, Jerums G, Stewart A, Gaskin CJ, Hare DL. Depressed mood, glycaemic control and functional capacity in overweight/obese men with and without type 2 diabetes. Diabetol Metab Syndr 2012; 4:46. [PMID: 23171832 PMCID: PMC3520815 DOI: 10.1186/1758-5996-4-46] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 11/20/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine whether there were differences in depressed mood between overweight/obese men with and without type 2 diabetes (T2DM) and to examine any associations between depressed mood, physical functioning, and glycaemic control in overweight/obese men with and without T2DM. METHODS Fifty seven overweight/obese men with (n = 19, age = 54.2 ± 7.4 yrs, BMI = 32.3 ± 6.7 kg⋅m-2) and without T2DM (n = 38, age = 51.1 ± 6.8 yrs, BMI = 29.9 ± 4.5kg⋅m-2, p > 0.05 between groups) participated. The men completed measures of depressed mood and health-related quality of life (HRQL) and underwent the following assessments: fasting blood lipids and glucose, HbA1c, anthropometric measurements, VO2peak, muscle strength, and physical function. RESULTS Compared to men without T2DM, men with T2DM had higher depressed mood (p = 0.05, η2 = 0.07), as well as lower perceived general health (p < .01, η2 = 0.24) and social functioning (p = .01, η2 = 0.10). Men with T2DM also had lower VO2peak (21.8 ± 5.3 versus 25.8 ± 5.4 ml⋅kg-1⋅min-1, p < .01, η2 = 0.11) and muscle strength (3.3 ± 0.8 versus 3.7 ± 0.7 kg⋅kg-1, p = 0.08, η2 = 0.06), as well as being slower to complete physical performance tasks (27.2 ± 5.2 versus 24.2 ± 2.8 sec, p < 0.01, η2 = 0.13). In those with T2DM, depressed mood was highly correlated with most HRQL subscales. For the combined cohort, depressed mood was correlated with fasting glucose (r = 0.31, p = 0.012) but not the functional measures. CONCLUSIONS Men with T2DM have higher levels of depressed mood compared to men without T2DM. Glycaemic control, but not functional capacities, is associated with depressed mood in the study cohort.
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Affiliation(s)
- Itamar Levinger
- Institute for Sport, Exercise and Active Living (ISEAL), School of Sport and Exercise Science, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia
- University of Melbourne and Department of Cardiology, Austin Health, Melbourne, Australia
| | - Steve Selig
- University of Melbourne and Department of Cardiology, Austin Health, Melbourne, Australia
- Centre for Exercise and Sports Science, School of Exercise & Nutrition Sciences, Deakin University, Melbourne, Australia
| | - George Jerums
- University of Melbourne and Department of Endocrinology, Austin Health, Melbourne, Australia
| | - Andrew Stewart
- University of Melbourne and Department of Cardiology, Austin Health, Melbourne, Australia
| | - Cadeyrn J Gaskin
- Centre for Exercise and Sports Science, School of Exercise & Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David L Hare
- University of Melbourne and Department of Cardiology, Austin Health, Melbourne, Australia
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Perera PK, Li Y. Functional herbal food ingredients used in type 2 diabetes mellitus. Pharmacogn Rev 2012; 6:37-45. [PMID: 22654403 PMCID: PMC3358966 DOI: 10.4103/0973-7847.95863] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 11/15/2010] [Accepted: 05/08/2012] [Indexed: 12/18/2022] Open
Abstract
From many reports it is clear that diabetes will be one of the major diseases in the coming years. As a result there is a rapidly increasing interest in searching new medicines, or even better searching prophylactic methods. Based on a large number of chemical and pharmacological research work, numerous bioactive compounds have been found in functional herbal food ingredients for diabetes. The present paper reviews functional herbal food ingredients with regards to their anti-diabetic active principles and pharmacological test results, which are commonly used in Asian culinary system and medical system and have demonstrated clinical or/and experimental anti-diabetic effectiveness. Our idea of reviewing this article is to give more attention to these functional food ingredients as targets medicinal foods in order to prevent or slow down the development of type 2 diabetes mellitus.
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Affiliation(s)
- Pathirage Kamal Perera
- Department of Physiology, China Pharmaceutical University, Nanjing, Jiangsu, P. R., China
| | - Yunman Li
- Department of Physiology, China Pharmaceutical University, Nanjing, Jiangsu, P. R., China
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Bae JS, Cheong HS, Kim JH, Park BL, Kim JH, Park TJ, Kim JY, Pasaje CFA, Lee JS, Park YJ, Park M, Park C, Koh I, Chung YJ, Lee JY, Shin HD. The genetic effect of copy number variations on the risk of type 2 diabetes in a Korean population. PLoS One 2011; 6:e19091. [PMID: 21526130 PMCID: PMC3081314 DOI: 10.1371/journal.pone.0019091] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 03/28/2011] [Indexed: 11/19/2022] Open
Abstract
Background Unlike Caucasian populations, genetic factors contributing to the risk of type 2 diabetes mellitus (T2DM) are not well studied in Asian populations. In light of this, and the fact that copy number variation (CNV) is emerging as a new way to understand human genomic variation, the objective of this study was to identify type 2 diabetes–associated CNV in a Korean cohort. Methodology/Principal Findings Using the Illumina HumanHap300 BeadChip (317,503 markers), genome-wide genotyping was performed to obtain signal and allelic intensities from 275 patients with type 2 diabetes mellitus (T2DM) and 496 nondiabetic subjects (Total n = 771). To increase the sensitivity of CNV identification, we incorporated multiple factors using PennCNV, a program that is based on the hidden Markov model (HMM). To assess the genetic effect of CNV on T2DM, a multivariate logistic regression model controlling for age and gender was used. We identified a total of 7,478 CNVs (average of 9.7 CNVs per individual) and 2,554 CNV regions (CNVRs; 164 common CNVRs for frequency>1%) in this study. Although we failed to demonstrate robust associations between CNVs and the risk of T2DM, our results revealed a putative association between several CNVRs including chr15:45994758–45999227 (P = 8.6E-04, Pcorr = 0.01) and the risk of T2DM. The identified CNVs in this study were validated using overlapping analysis with the Database of Genomic Variants (DGV; 71.7% overlap), and quantitative PCR (qPCR). The identified variations, which encompassed functional genes, were significantly enriched in the cellular part, in the membrane-bound organelle, in the development process, in cell communication, in signal transduction, and in biological regulation. Conclusion/Significance We expect that the methods and findings in this study will contribute in particular to genome studies of Asian populations.
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Affiliation(s)
- Joon Seol Bae
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
| | - Hyun Sub Cheong
- Department of Genetic Epidemiology, SNP Genetics, Inc., Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Hong Kim
- Integrated Research Center for Genome Polymorphism, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Hospital Pathology, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung Lae Park
- Department of Genetic Epidemiology, SNP Genetics, Inc., Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
| | - Tae Joon Park
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
| | - Jason Yongha Kim
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
| | - Charisse Flerida A. Pasaje
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
| | - Jin Sol Lee
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
| | - Yun-Ju Park
- Center for Genome Sciences, National Institute of Health (NIH), Osong, Republic of Korea
| | - Miey Park
- Center for Genome Sciences, National Institute of Health (NIH), Osong, Republic of Korea
| | - Chan Park
- Center for Immunology and Pathology, National Institute of Health (NIH), Osong, Republic of Korea
| | - InSong Koh
- Department of Physiology, College of Medicine, Hanyang University, Seoul, Korea
| | - Yeun-Jun Chung
- Integrated Research Center for Genome Polymorphism, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Hospital Pathology, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Young Lee
- Center for Genome Sciences, National Institute of Health (NIH), Osong, Republic of Korea
- * E-mail: (J-YL); (HDS)
| | - Hyoung Doo Shin
- Laboratory of Genomic Diversity, Department of Life Science, Sogang University, Seoul, Republic of Korea
- Department of Genetic Epidemiology, SNP Genetics, Inc., Seoul, Republic of Korea
- * E-mail: (J-YL); (HDS)
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Zhao T, Liu Z, Zhang D, Liu Y, Yang Y, Zhou D, Chen Z, Yu L, Zhang Z, Feng G, He L, Xu H. The ENPP1 K121Q polymorphism is not associated with type 2 diabetes or obesity in the Chinese Han population. J Hum Genet 2010; 56:12-6. [PMID: 20981035 DOI: 10.1038/jhg.2010.124] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Amed S, Daneman D, Mahmud FH, Hamilton J. Type 2 diabetes in children and adolescents. Expert Rev Cardiovasc Ther 2010; 8:393-406. [PMID: 20222817 DOI: 10.1586/erc.10.15] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The emergence of Type 2 diabetes (T2D) in children and adolescents parallels the rising rates of childhood obesity. As a condition of impaired insulin sensitivity and relative insulin deficiency resulting in hyperglycemia, T2D has a complex underlying physiology that is reflected by the multiple approaches used to optimize medical care and prevent the myriad of diabetes-related complications. T2D diagnosed in children and adolescents represents a distinct and challenging condition to evaluate and treat. Here, we highlight the epidemiology, pathophysiology, risk factors, clinical presentation and diagnosis, treatment and public health impact of T2D in children and adolescents.
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Affiliation(s)
- Shazhan Amed
- The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada
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Surampudi PN, John-Kalarickal J, Fonseca VA. Emerging concepts in the pathophysiology of type 2 diabetes mellitus. ACTA ACUST UNITED AC 2009; 76:216-26. [PMID: 19421965 DOI: 10.1002/msj.20113] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Type 2 diabetes mellitus is a multifactorial metabolic disorder. It is characterized by chronic hyperglycemia, insulin resistance, and a relative insulin secretion defect. The prevalence of type 2 diabetes mellitus has risen worldwide in large part because of an increase in obesity and sedentary lifestyles. The underlying pathophysiology and complications of type 2 diabetes mellitus are still being elucidated. Recent advances in diabetes research have helped us to gain a better understanding about insulin resistance and insulin secretion defects. The evolving understanding about the influence of the incretin effect, insulin signal transduction, adipose tissue, intra-islet cell communication, and inflammation is changing the way in which we view type 2 diabetes mellitus. This new understanding will eventually provide us with new treatment approaches to help patients who have type 2 diabetes mellitus. This article gives a review of the current and emerging concepts of the pathophysiology of type 2 diabetes mellitus.
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Abstract
PURPOSE OF REVIEW To highlight recent type 2 diabetes (T2D)-associated genetic discoveries and their potential for clinical application. RECENT FINDINGS The advent of genome-wide association screening has uncovered many loci newly associated with T2D. This review describes the techniques applied to discover novel T2D genes and compares their relative strengths, biases, and findings to date. The results of large-scale genome-wide association studies carried out since 2007 are summarized, and limitations of interpreting this preliminary data are offered. Recent studies exploring the clinical potential of these discoveries are reviewed, focusing on insights into T2D pathogenesis, risk prediction of future diabetes, and utility in guiding pharmacotherapy. The new T2D-associated loci have been implicated in beta-cell development and function, highlighting insulin secretion in the disease process. Preliminary risk prediction studies show that more loci are needed to improve T2D risk indices. Studies have also revealed that genes may play a role in the pharmacologic response to antidiabetic medications. SUMMARY Since 2007, genome-wide association studies have rapidly increased the number of T2D-associated loci. This review summarizes the history of genetic association studies, the results from the new genome-wide association studies, and the clinical application of these findings.
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Affiliation(s)
- Amit R Majithia
- Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston, Boston, MA 02114, USA
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Fang XK, Gao Y, Yang HY, Lang SM, Wang QJ, Yu BY, Zhu DN. Alleviating effects of active fraction of Euonymus alatus abundant in flavonoids on diabetic mice. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2008; 36:125-40. [PMID: 18306456 DOI: 10.1142/s0192415x08005643] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Euonymus alatus (E. alatus) has been used as a folk medicine for diabetes in China for more than one thousand years. In order to identify major active components, effects of different fractions of E. alatus on the plasma glucose levels were investigated in normal mice and alloxan-induced diabetic mice. Our results show that ethyl acetate fraction (EtOAc Fr.) displayed significant effects on reducing plasma glucose. In oral glucose tolerance, EtOAc Fr. at 17.2 mg/kg could significantly decrease the blood glucose of both normal mice and diabetic mice. After 4 weeks administration of the EtOAc Fr, when compared with the diabetic control, there were significant difference in biochemical parameters, such as glycosylated serum protein, superoxide dismutase and malondial dehyde, triglyceride, and total cholesterol, between alloxan-induced diabetic mice and the control group. Additional histopathological studies of pancreatic islets also showed EtOAc Fr. has beneficial effects on diabetic mice. Chemical analysis with three-dimensional HPLC demonstrated that the major components from EtOAc Fr were flavonoids and phenolic acids, which had anti-oxidative effects on scavenging DPPH-radical in vitro. All these experimental results suggest that EtOAc Fr. is an active fraction of E. alatus and can prevent the progress of diabetes. The mechanism of E. alatus for glucose control may be by stimulating insulin release, improving glucose uptake and improving oxidative-stress.
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Affiliation(s)
- Xian-Kang Fang
- Department of Traditional Chinese Prescription, China Pharmaceutical University, 1 Shennong Road, Nanjing 210038, China
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12
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Hays NP, Galassetti PR, Coker RH. Prevention and treatment of type 2 diabetes: current role of lifestyle, natural product, and pharmacological interventions. Pharmacol Ther 2008; 118:181-91. [PMID: 18423879 DOI: 10.1016/j.pharmthera.2008.02.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Accepted: 02/07/2008] [Indexed: 02/07/2023]
Abstract
Common complications of type 2 diabetes (T2D) are eye, kidney and nerve diseases, as well as an increased risk for the development of cardiovascular disease and cancer. The overwhelming influence of these conditions contributes to a decreased quality of life and life span, as well as significant economic consequences. Although obesity once served as a surrogate marker for the risk of T2D, we know now that excess adipose tissue secretes inflammatory cytokines that left unchecked, accelerate the progression to insulin resistance and T2D. In addition, excess alcohol consumption may also increase the risk of T2D. From a therapeutic standpoint, lifestyle interventions such as dietary modification and/or exercise training have been shown to improve glucose homeostasis but may not normalize the disease process unless weight loss is achieved and increased physical activity patterns are established. Furthermore, utilization of natural products may serve as a significant adjunct in the fight against insulin resistance but further research is needed to ascertain their validity. Since it is clear that pharmaceutical therapy plays a significant role in the treatment of insulin resistance, this review will also discuss some of the newly developed pharmaceutical therapies that may work in conjunction with lifestyle interventions, and lessen the burden of behavioral change as the only strategy against the development of T2D.
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Affiliation(s)
- Nicholas P Hays
- Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
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13
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Moore AF, Florez JC. Genetic Susceptibility to Type 2 Diabetes and Implications for Antidiabetic Therapy. Annu Rev Med 2008; 59:95-111. [DOI: 10.1146/annurev.med.59.090706.135315] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Allan F. Moore
- Diabetes Unit (Department of Medicine) and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts; the Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts; and the Department of Medicine, Harvard Medical School, Boston, Massachusetts;
| | - Jose C. Florez
- Diabetes Unit (Department of Medicine) and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts; the Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts; and the Department of Medicine, Harvard Medical School, Boston, Massachusetts;
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14
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Abstract
The rapid increase in the population prevalence of type 2 diabetes mellitus (T2DM) in youth can only be explained by changes in lifestyle. However, even when most members of a population have changed their lifestyle, only a minority of children develop diabetes, and genetic factors are important in determining which children are affected. Support for the role of genetic factors comes from epidemiological evidence that diabetes in youth is most common in high diabetes prevalence racial groups, in subjects with a strong family history, and in girls. Defining the genes predisposing to T2DM is extremely difficult as there are multiple genes involved each contributing only a small amount and lifestyle factors play a large role. Defining the molecular genetics of T2DM in youth is even harder because in addition to the low number of subjects, there is also the ethnic heterogeneity of the subjects and the lack of robust diagnostic criteria. Recently, there has been considerable progress in defining the predisposing genes for adults with T2DM using thousands of cases and controls and a collaborative genome-wide approach. Similar numbers will be needed to assess if the genes found in adults also predispose to T2DM of youth and this will require large multi-center studies. Progress to date in the molecular genetics of T2DM in youth is limited to one population, the Oji-Cree Native Canadians, where the private variant - G319S - a variant of HNF1A strongly predisposes to diabetes in children as well as in adults.
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Affiliation(s)
- Olivia Gill-Carey
- Institute of Biomedical and Clinical Sciences, Peninsula Medical School, Barrack Road, Exeter, UK
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15
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Laakso M. Challenges in studies of the genetic basis of Type 2 diabetes. Expert Rev Endocrinol Metab 2007; 2:451-459. [PMID: 30290420 DOI: 10.1586/17446651.2.4.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The prevalence of diabetes is increasing worldwide in epidemic proportions. This increase is mainly due to increased incidence and prevalence of Type 2 diabetes, which accounts for 80-90% of all cases of diabetes. The susceptibility to develop Type 2 diabetes is determined by genetic and environmental factors. Major genes responsible for Type 2 diabetes have not yet been identified. The most replicated susceptibility gene for Type 2 diabetes is TCF7L2, recently published by investigators from Iceland. The second most widely replicated association between a genetic variation and the risk of Type 2 diabetes is that of the Pro12Ala polymorphism in the peroxisome proliferator-activated receptor γ2 gene. Furthermore, the common E23K polymorphism in the KCJN11 gene, encoding the ATP-sensitive potassium-channel subunit Kir6.2, and variants in the calpain-10 gene have been associated with increased susceptibility to Type 2 diabetes in meta-analyses. Several studies have investigated the possibility that rare, highly penetrant mutations in the maturity-onset diabetes of the young genes lead to monogenic diabetes, while common polymorphisms increase the susceptibility to Type 2 diabetes. Indeed, there is increasing evidence that single nucleotide polymorphisms in hepatic nuclear factor-4α are significantly associated with the risk of Type 2 diabetes. In this review, different approaches to identify susceptibility genes for Type 2 diabetes are discussed. In particular, the importance of prospective population-based cohort studies and prospective intervention studies are emphasized. Finally, genome-wide association studies using single nucleotide polymorphisms randomly spaced across the entire genome may be useful in the identification of susceptibility genes for Type 2 diabetes.
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Affiliation(s)
- Markku Laakso
- a Academy Professor, Department of Medicine, University of Kuopio and Kuopio University Hospital, 70210 Kuopio, Finland.
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Eriksson JG, Lehtovirta M, Ehrnström B, Salmela S, Groop L. Long-term beneficial effects of glipizide treatment on glucose tolerance in subjects with impaired glucose tolerance. J Intern Med 2006; 259:553-60. [PMID: 16704555 DOI: 10.1111/j.1365-2796.2006.01633.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS To assess the efficacy and long-term effects of glipizide treatment on glucose and insulin metabolism in individuals with impaired glucose tolerance (IGT). METHODS Thirty-seven first-degree relatives of patients with type 2 diabetes fulfilling WHO criteria for IGT were randomized to treatment with either glipizide 2.5 mg once daily or matching placebo for 6 months. A 75 g, 2-h oral (OGTT) and 60 min intravenous glucose tolerance test (IVGTT) were performed at baseline and after 6 months. The subjects were followed up for another 12 months after discontinuation of treatment and a repeat OGTT was performed at 18 months. RESULTS Thirty-three subjects fulfilled the study. Markers of insulin sensitivity - i.e. fasting insulin and HOMA(IR)-index - improved in the glipizide group (P = 0.04 and 0.02 respectively) as well as HDL cholesterol (P = 0.05) compared with placebo group after 6 months. At 18 months, both fasting and 2 h glucose concentrations were significantly lower in the glipizide group compared with the placebo group (P = 0.04 and 0.03 respectively). The prevalence of type 2 diabetes was 29.4% in the placebo group and 5.9% in the glipizide group at 18 months. This equals an 80% relative risk reduction in the active treatment group. CONCLUSIONS Short-term treatment with glipizide improves glucose and insulin metabolism in subjects with IGT primarily by improving insulin sensitivity mediated by lowering glucose toxicity, thereby providing the beta cells rest. Larger studies are needed to establish whether these effects are sufficient to prevent progression to manifest type 2 diabetes and associated cardiovascular morbidity in subjects at increased risk of developing type 2 diabetes.
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Affiliation(s)
- J G Eriksson
- Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
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Grulich-Henn J. Genetik des Diabetes mellitus Typ 2 und verwandter Diabetesformen. Monatsschr Kinderheilkd 2005. [DOI: 10.1007/s00112-005-1225-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
African Americans and other ethnic minority groups suffer disproportionately from type 2 diabetes and its complications than do white Americans. Genetic and environmental factors contribute to the ethnic disparities in diabetes and its complications. The key elements of a comprehensive diabetes management strategy include monitoring, education, dietary modification, exercise, and medications. The progressive nature of diabetes requires the use of more than one agent. Drug combinations should be selected for their therapeutic fire power and complementary mechanisms of action, and exogenous insulin need not be delayed unnecessarily if oral agents are ineffective.
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Affiliation(s)
- Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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Abstract
Type 2 diabetes (T2D) has become a health-care problem worldwide, with the rise in disease prevalence being all the more worrying as it not only affects the developed world but also developing nations with fewer resources to cope with yet another major disease burden. Furthermore, the problem is no longer restricted to the ageing population, as young adults and children are also being diagnosed with T2D. In recent years, there has been a surge in the number of genetic studies of T2D in attempts to identify some of the underlying risk factors. In this review, I highlight the main genes known to cause uncommon monogenic forms of diabetes (e.g. maturity-onset diabetes of the young--MODY--and insulin resistance syndromes), as well as describe some of the main approaches used to identify genes involved in the more common forms of T2D that result from the interaction between environmental risk factors and predisposing genotypes. Linkage and candidate gene studies have been highly successful in the identification of genes that cause the monogenic variants of diabetes and, although progress in the more common forms of T2D has been slow, a number of genes have now been reproducibly associated with T2D risk in multiple studies. These are discussed, as well as the main implications that the diabetes gene discoveries will have in diabetes treatment and prevention.
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Affiliation(s)
- I Barroso
- Metabolic Disease Group, The Wellcome Trust Sanger Institute, Cambridge, UK.
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Ikarashi T, Hanyu O, Maruyama S, Souda S, Kobayashi C, Abe E, Ukisu J, Naganuma K, Suzuki A, Toya M, Kaneko S, Suzuki K, Nakagawa O, Aizawa Y. Genotype Gly/Gly of the Arg16Gly polymorphism of the beta2-adrenergic receptor is associated with elevated fasting serum insulin concentrations, but not with acute insulin response to glucose, in type 2 diabetic patients. Diabetes Res Clin Pract 2004; 63:11-8. [PMID: 14693408 DOI: 10.1016/j.diabres.2003.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The beta(2)-adrenergic receptor (B2AR) is expressed in pancreatic beta-cells and modulates insulin secretion. The purpose of the present study was to evaluate the influence of the Arg16Gly variant allele of B2AR on insulin secretion in patients with type 2 diabetes. We used minimal model analysis of the frequently sampled insulin-modified intravenous glucose tolerance test (FSIGT) and polymerase chain reaction (PCR)-restriction fragment length polymorphism to examine differences of insulin secretion and insulin resistance among three genotypes. There were no significant differences in baseline clinical characteristics, HbA1c, uric acid, CRP or lipid profiles among the three groups. The Gly/Gly group had significantly higher levels of fasting insulin (38.2+/-4.7 pmol/l versus 23.6+/-3.5 pmol/l) and homeostasis model assessment of insulin resistance (HOMA-R) (1.90+/-0.19 versus 1.32+/-0.24), compared with the Arg/Arg group, but there were no significant differences in acute insulin response to glucose (AIRg) bolus, insulin sensitivity (Si), or glucose effectiveness (Sg) among the three genotypes. Several reports have speculated that the Gly16 allele of B2AR exhibits agonist-promoted downregulation, but our findings, elevated fasting insulin concentrations, and previous clinical studies of blood pressure and lypolysis are controversial. The direct mechanism by which the Gly16 allele of B2AR may influence insulin secretion of pancreatic beta-cells is unknown. Further studies of the expression of the allelic receptor in islet cells may help to resolve the role of B2AR in insulin secretion. However, increased sensitivity to catecholamine-induced lipolysis of the Gly allele promotes higher free fatty acids concentrations in the portal system, which could enhance the higher levels of fasting insulin.
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Affiliation(s)
- Tomoo Ikarashi
- Division of Endocrinology and Metabolism, Niigata University Graduate School of Medical and Dental Sciences, 1-754 Asahimachi-dori, 951-8510, Niigata, Japan
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Ylönen K, Alfthan G, Groop L, Saloranta C, Aro A, Virtanen SM. Dietary intakes and plasma concentrations of carotenoids and tocopherols in relation to glucose metabolism in subjects at high risk of type 2 diabetes: the Botnia Dietary Study. Am J Clin Nutr 2003; 77:1434-41. [PMID: 12791620 DOI: 10.1093/ajcn/77.6.1434] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The role of antioxidants in the pathogenesis of type 2 diabetes is uncertain. OBJECTIVE We evaluated cross-sectional relations of dietary intakes and plasma concentrations of antioxidants with glucose metabolism in a high-risk population. DESIGN The subjects were 81 male and 101 female first- and second-degree, nondiabetic relatives of patients with type 2 diabetes. Antioxidant intake data were based on 3-d food records. Subjects taking supplements containing beta-carotene or alpha-tocopherol were excluded. Plasma antioxidant concentrations were measured by HPLC. By using multiple linear regression analysis and adjusting for demographic, anthropometric, and lifestyle covariates, we studied whether dietary and plasma alpha- and beta-carotene, lycopene, and alpha- and gamma-tocopherol were related to fasting and 2-h concentrations of glucose and nonesterified fatty acids during an oral-glucose-tolerance test, to the homeostasis model assessment index of insulin resistance, and to measures of beta cell function (incremental 30-min serum insulin concentration during an oral-glucose-tolerance test and first-phase insulin secretion during an intravenous-glucose-tolerance test). RESULTS In men, dietary carotenoids were inversely associated with fasting plasma glucose concentrations (P < 0.05), plasma beta-carotene concentrations were inversely associated with insulin resistance (P = 0.003), and dietary lycopene was directly related to baseline serum concentrations of nonesterified fatty acids (P = 0.034). In women, dietary alpha-tocopherol and plasma beta-carotene concentrations were inversely and directly associated, respectively, with fasting plasma glucose concentrations (P < 0.05). In both sexes, cholesterol-adjusted alpha-tocopherol concentrations were directly associated with 2-h plasma glucose concentrations (P < 0.05). CONCLUSION The data suggest an advantageous association of carotenoids, which are markers of fruit and vegetable intake, with glucose metabolism in men at high risk of type 2 diabetes.
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Affiliation(s)
- Katriina Ylönen
- Department of Applied Chemistry and Microbiology, Division of Nutrition, University of Helsinki, Finland.
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Zammit VA. Insulin stimulation of hepatic triacylglycerol secretion in the insulin-replete state: implications for the etiology of peripheral insulin resistance. Ann N Y Acad Sci 2002; 967:52-65. [PMID: 12079835 DOI: 10.1111/j.1749-6632.2002.tb04263.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Observations on humans, on rats in vivo, and on isolated perfused rat livers indicate that insulin stimulates hepatic very-low-density lipoprotein (VLDL)-TAG secretion when the liver is chronically exposed to the hormone. They suggest that frequent stimulation of insulin secretion throughout the diurnal cycle may result in a chronic stimulation of VLDL secretion and increased delivery of acyl moieties to the periphery, particularly to muscle, the most important site of insulin-sensitive glucose disposal. If acyl groups are provided in excess of the oxidative needs of the tissue, this may lead to induction of insulin resistance, irrespective of whether obesity is established concomitantly. Dietary factors that stimulate hepatic VLDL secretion may have the same effect and contribute to the induction of a vicious spiral leading to the development of the full-blown Metabolic Syndrome and its pathological consequences, including type-2 diabetes, stroke, and cardiovascular disease.
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Affiliation(s)
- Victor A Zammit
- Cell Biochemistry, Hannah Research Institute, Ayr KA6 5HL, Scotland, United Kingdom.
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Lindgren CM, Widén E, Tuomi T, Li H, Almgren P, Kanninen T, Melander O, Weng J, Lehto M, Groop LC. Contribution of known and unknown susceptibility genes to early-onset diabetes in scandinavia: evidence for heterogeneity. Diabetes 2002; 51:1609-17. [PMID: 11978663 DOI: 10.2337/diabetes.51.5.1609] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In an attempt to identify novel susceptibility genes predisposing to early-onset diabetes (EOD), we performed a genome-wide scan using 433 markers in 222 individuals (119 with diabetes) from 29 Scandinavian families with > or =2 members with onset of diabetes < or =45 years. The highest nonparametric linkage (NPL) score, 2.7 (P < 0.01), was observed on chromosome 1p (D1S473/D1S438). Six other regions on chromosomes 3p, 7q, 11q, 18q, 20q, and 21q showed a nominal P value <0.05. Of the EOD subjects in these 29 families, 20% were GAD antibody positive and 68% displayed type 1 diabetes HLA risk alleles (DQB*02 or 0302). Mutations in maturity-onset diabetes of the young (MODY) 1-5 genes and the A3243G mitochondrial DNA mutation were detected by single-strand conformation polymorphism and direct sequencing. To increase homogeneity, we analyzed a subsample of five families with autosomal dominant inheritance of EOD (greater than or equal to two members with age at diagnosis < or =35 years). The highest NPL scores were found on chromosome 1p (D1S438-D1S1665; NPL 3.0; P < 0.01) and 16q (D16S419; NPL 2.9; P < 0.01). After exclusion of three families with MODY1, MODY3, and mitochondrial mutations, the highest NPL scores were observed on chromosomes 1p (D1S438; NPL 2.6; P < 0.01), 3p (D3S1620; NPL 2.2; P < 0.03), 5q (D5S1465; NPL 2.1; P < 0.03), 7q (D7S820; NPL 2.0; P < 0.03), 18q (D18S535; NPL 1.9; P < 0.04), 20q (D20S195; NPL 2.5; P < 0.02), and 21q (D21S1446; NPL 2.2; P < 0.03). We conclude that considerable heterogeneity exists in Scandinavian subjects with EOD; 24% had MODY or maternally inherited diabetes and deafness, and approximately 60% were GAD antibody positive or had type 1 diabetes-associated HLA genotypes. Our data also point at putative chromosomal regions, which could harbor novel genes that contribute to EOD.
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Affiliation(s)
- Cecilia M Lindgren
- Department of Endocrinology, Wallenberg laboratory, Malmö University Hospital, Malmö, Sweden.
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Balasse EO. Monosaccharide esters: clinically relevant? Acta Clin Belg 2002; 57:47-8. [PMID: 12152237 DOI: 10.1179/acb.2002.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lindgren CM, Mahtani MM, Widén E, McCarthy MI, Daly MJ, Kirby A, Reeve MP, Kruglyak L, Parker A, Meyer J, Almgren P, Lehto M, Kanninen T, Tuomi T, Groop LC, Lander ES. Genomewide search for type 2 diabetes mellitus susceptibility loci in Finnish families: the Botnia study. Am J Hum Genet 2002; 70:509-16. [PMID: 11791216 PMCID: PMC384923 DOI: 10.1086/338629] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2001] [Accepted: 11/05/2001] [Indexed: 12/17/2022] Open
Abstract
Type 2 diabetes mellitus is a heterogeneous inherited disorder characterized by chronic hyperglycemia resulting from pancreatic beta-cell dysfunction and insulin resistance. Although the pathogenic mechanisms are not fully understood, manifestation of the disease most likely requires interaction between both environmental and genetic factors. In the search for such susceptibility genes, we have performed a genomewide scan in 58 multiplex families (comprising 440 individuals, 229 of whom were affected) from the Botnia region in Finland. Initially, linkage between chromosome 12q24 and impaired insulin secretion had been reported, by Mahtani et al., in a subsample of 26 families. In the present study, we extend the initial genomewide scan to include 32 additional families, update the affectation status, and fine map regions of interest, and we try to replicate the initial stratification analysis. In our analysis of all 58 families, we identified suggestive linkage to one region, chromosome 9p13-q21 (nonparametric linkage [NPL] score 3.9; P<.0002). Regions with nominal P values <.05 include chromosomes 2p11 (NPL score 2.0 [P<.03]), 3p24-p22 (NPL score 2.2 [P<.02]), 4q32-q33 (NPL score 2.5 [P<.01]), 12q24 (NPL score 2.1 [P<.03]), 16p12-11 (NPL score 1.7 [P<.05]), and 17p12-p11 (NPL score 1.9 [P<.03]). When chromosome 12q24 was analyzed in only the 32 additional families, a nominal P value <.04 was observed. Together with data from other published genomewide scans, these findings lend support to the hypothesis that regions on chromosome 9p13-q21 and 12q24 may harbor susceptibility genes for type 2 diabetes.
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Affiliation(s)
- C M Lindgren
- Department of Endocrinology, Wallenberg Laboratory, Malmö University Hospital, Malmö, Sweden
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Abstract
The first unifying definition for the metabolic syndrome was proposed by WHO in 1998. In accordance to this, patients with type 2 diabetes mellitus or impaired glucose tolerance have the syndrome if they fulfil two of the criteria: hypertension, dyslipidaemia, obesity/abdominal obesity and microalbuminuria. Persons with normal glucose tolerance (NGT) should also be insulin resistant. About 40% of persons with impaired glucose tolerance (IGT) and 70% of patients with type 2 diabetes have features of the syndrome. Importantly, presence of the dysmetabolic syndrome is associated with reduced survival, particularly because of increased cardiovascular mortality. The dysmetabolic syndrome most likely results from interplay between several genes and an affluent environment. Compatible with the thrifty gene theory, common variants in genes regulating lipolysis, thermogenesis and glucose uptake in skeletal muscle account for a large part of such thrifty genes. However, hitherto unknown genes may still be identified by random gene approaches.
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Affiliation(s)
- L Groop
- Department of Endocrinology, Wallenberg Laboratory, Lund University, Malmö, Sweden.
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Lehtovirta M, Forsén B, Gullström M, Häggblom M, Eriksson JG, Taskinen MR, Groop L. Metabolic effects of metformin in patients with impaired glucose tolerance. Diabet Med 2001; 18:578-83. [PMID: 11553189 DOI: 10.1046/j.1464-5491.2001.00539.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS To assess the effect of metformin on insulin sensitivity, glucose tolerance and components of the metabolic syndrome in patients with impaired glucose tolerance (IGT). METHODS Forty first-degree relatives of patients with Type 2 diabetes fulfilling WHO criteria for IGT and participating in the Botnia study in Finland were randomized to treatment with either metformin 500 mg b.i.d. or placebo for 6 months. An oral glucose tolerance test (OGTT) and a euglycaemic hyperinsulinaemic clamp in combination with indirect calorimetry was performed at 0 and 6 months. The patients were followed after stopping treatment for another 6 months in an open trial and a repeat OGTT was performed at 12 months. RESULTS Metformin treatment resulted in a 20% improvement in insulin-stimulated glucose metabolism (from 28.7 +/- 13 to 34.4 +/- 10.7 micromol/kg fat-free mass (FFM)/min) compared with placebo (P = 0.01), which was primarily due to an increase in glucose oxidation (from 16.6 +/- 3.6 to 19.1 +/- 4.4 micromol/kg FFM; P = 0.03) These changes were associated with a minimal improvement in glucose tolerance, which was maintained after 12 months. CONCLUSIONS Metformin improves insulin sensitivity in subjects with IGT primarily by reversal of the glucose fatty acid cycle. Obviously large multicentre studies are needed to establish whether these effects are sufficient to prevent progression to manifest Type 2 diabetes and associated cardiovascular morbidity and mortality. Diabet. Med. 18, 578-583 (2001)
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Affiliation(s)
- M Lehtovirta
- Department of Medicine, Helsinki University Hospital, Helsinki, Finland
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Kim JH, Sen S, Avery CS, Simpson E, Chandler P, Nishina PM, Churchill GA, Naggert JK. Genetic analysis of a new mouse model for non-insulin-dependent diabetes. Genomics 2001; 74:273-86. [PMID: 11414755 DOI: 10.1006/geno.2001.6569] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The TallyHo (TH) mouse strain is a newly established model for non-insulin-dependent diabetes mellitus (NIDDM). TH mice show obesity, hyperinsulinemia, hyperlipidemia, and male-limited hyperglycemia. A genetic dissection of the diabetes syndrome has been carried out using male backcross 1 progeny obtained from crosses between (C57BL/6J x TH)F1 and TH mice or (CAST/Ei x TH)F1 and TH mice. A genome-wide scan reveals three quantitative trait loci (QTLs), Tanidd1-3 (TH-associated NIDDM) linked to hyperglycemia. The major QTL (common in both crosses), Tanidd1, maps to chromosome (Chr) 19. Additionally, gene-gene interactions contributing to hyperglycemia have been observed between Tanidd1 and a locus on Chr 18 as well as between Tanidd2 and a locus on Chr 16. The overt hyperglycemia in TH mice is, therefore, likely due to a mutation in a major diabetes susceptibility locus on Chr 19, which interacts with additional genes to lead to an observable phenotype.
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Affiliation(s)
- J H Kim
- The Jackson Laboratory, Bar Harbor, Maine 04609, USA
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29
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Abstract
Genetic analysis of growth from birth to adulthood shows the existence of a strong genetic component in the variance of size at particular milestones in the growth process, such as height at take-off, at peak velocity and at adulthood. While it is well known that postnatal growth is strongly genetically determined, the importance of genes in normal variations of prenatal growth is less known. Genetic analysis of prenatal growth in human is not an easy problem and weighing the genetic and non-genetic component in intra-uterine growth retardation an almost impossible task. It is now well known that adults who had a low birthweight or who were thin at birth, with a low ponderal index, tend to be insulin resistant and have an increased risk of developing non-insulin-dependent diabetes mellitus later in life. According to the thrifty genotype hypothesis, genes predisposing to type 2 diabetes mellitus are very likely to have been survival genes for our ancestors, helping them to store energy during long periods of starvation. Both epidemiological surveys of adults born after prenatal exposure to exposure to famine and biochemical investigations of insulin resistance in low birthweight children show that the association between a low birthweight and an increased risk of developing type 2 diabetes mellitus later in life has a genetic basis. While low birthweight infants have a decreased survival probability in infancy, having a small baby may have been a selective advantage during long periods of starvation. This could explain why the same genetic variants cause low birthweight phenotype and insulin resistance predisposing to non-insulin-dependent diabetes.
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Affiliation(s)
- M Jeanpierre
- Laboratoire de génétique moléculaire, centre hospitalier Cochin-Port-Royal, Paris, France
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Garvey WT, Hermayer KL. Clinical implications of the insulin resistance syndrome. CLINICAL CORNERSTONE 2000; 1:13-28. [PMID: 10682170 DOI: 10.1016/s1098-3597(98)90015-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Insulin resistance syndrome (IRS), also termed syndrome X, is a distinctive constellation of risk factors for the development of type 2 diabetes mellitus and cardiovascular disease. The syndrome's hallmarks are glucose intolerance, hyperinsulinemia, a characteristic dyslipidemia (high triglycerides; low high-density lipoprotein cholesterol, and small, dense low-density lipoprotein cholesterol), obesity, upper-body fat distribution, hypertension, and increased prothrombotic and antifibrinolytic factors. Insulin resistance, caused by a complex of genetic and environmental influences, is now recognized not just as a mechanism contributing to hyperglycemia in type 2 diabetes, but also as an early metabolic abnormality that precedes the development of overt diabetes. The clinical definition of insulin resistance is the impaired ability of insulin (either endogenous or exogenous) to lower blood glucose. In some insulin-resistant individuals, insulin secretion will begin to deteriorate under chronic stress (glucose toxicity) and overt diabetes will result. If not, individuals will remain hyperinsulinemic, with perhaps some degree of glucose intolerance, together with other hallmarks of the IRS. The statistical correlation between hypertension and impaired glucose tolerance is clear, although the mechanism is not yet fully understood. Epidemiologic evidence of insulin resistance as an independent risk factor for atherosclerosis and coronary heart disease (CHD) completed the evolving concept of IRS as the common soil for the development of both diabetes and CHD. No single laboratory test exists for diagnosis of IRS. Rather, IRS remains a clinically evident syndrome that can be suspected on the basis of physical and laboratory findings. This identifies individual patients whom the clinician should screen for associated comorbid conditions, aggressively control cardiovascular risk factors, and tailor drug therapy for optimal benefit. This article provides practical guidelines to achieve these goals and specific strategies to ameliorate cardiovascular and metabolic risk in the IRS.
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Affiliation(s)
- W T Garvey
- Division of Endocrinology, Diabetes, and Medical Genetics, Medical University of South Carolina, Charleston, USA
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31
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Abstract
The clustering of cardiovascular risk factors such as abdominal obesity, hypertension, dyslipidaemia and glucose intolerance in the same persons has been called the metabolic or insulin-resistance syndrome. In 1998 WHO proposed a unifying definition for the syndrome and chose to call it the metabolic syndrome rather than the insulin-resistance syndrome. Although insulin resistance has been considered as a common denominator for the different components of the syndrome, there is still debate as to whether it is pathogenically involved in all of the different components of the syndrome. Clustering of the syndrome in families suggests a genetic component. It is plausible that so-called thrifty genes, which have ensured optimal storage of energy during periods of fasting, could contribute to the phenotype of the metabolic syndrome. Common variants in a number of candidate genes influencing fat and glucose metabolism can probably, together with environmental triggers, increase susceptibility to the syndrome. Among these, the genes for beta 3-adrenergic receptor, hormone-sensitive lipase, lipoprotein lipase, IRS-1, PC-1, skeletal muscle glycogen synthase, etc. appear to increase the risk of the metabolic syndrome. In addition, novel genes may be identified by genome-wide searches.
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Affiliation(s)
- L Groop
- Department of Endocrinology, University Hospital MAS, Lund University, Malmö, Sweden.
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Siffert W, Rosskopf D, Erbel R. [Genetic polymorphism of the G-protein beta3 subunit, obesity and essential hypertension]. Herz 2000; 25:26-33. [PMID: 10713907 DOI: 10.1007/bf03044121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Following a classical candidate gene approach we have detected a C825T polymorphism in the gene GNB3 which encodes the G beta 3 subunit of heterotrimeric G proteins. The 825T allele causes alternative splicing of the gene and the generation of a truncated but functionally active splice variant of G beta 3 which is referred to as G beta 3s. Thus, genotyping for the C825T polymorphism is predictive for the activation of certain G proteins in humans. The 825T allele is significantly associated with an increased risk for hypertension in Caucasians, most likely "low renin hypertension" and it accumulates significantly in individuals with a strong family history of hypertension. Highest frequencies of the 825T allele (up to 80%) are found in old ethnicities, e.g. black Africans, African Americans, bushmen, and Australian aborigines. This suggests that enhanced G protein activation represents a thrifty genotype which might have facilitated survival in our ancestors. Frequencies of the 825T allele are significant lower in Asians (approximately 40 to 50%) and Caucasians (30%). More recent studies show that young 825T allele carriers are predisposed for obesity and this association could be confirmed across different ethnicities including young Germans, as well as Chinese and black African individuals. Thus, genotyping at the GNB3 locus represents an ideal tool for preventive medicine in that individuals at risk for obesity and hypertension can be identified early and counteract their genetic predisposition through changes in lifestyle. In individuals with borderline hypertension genotyping can facilitate the decision for medical treatment as a positive test result confirms an inherited form of hypertension.
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Affiliation(s)
- W Siffert
- Institut für Pharmakologie, Universitätsklinikum Essen.
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Groop LC. Pathogenesis of insulin resistance in type 2 diabetes: a collision between thrifty genes and an affluent environment. Drugs 1999; 58 Suppl 1:11-2; discussion 75-82. [PMID: 10576518 DOI: 10.2165/00003495-199958001-00004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- L C Groop
- University Hospital Malmö, University of Lund, Sweden.
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Baschetti R. Diabetes epidemic in newly westernized populations: is it due to thrifty genes or to genetically unknown foods? J R Soc Med 1998; 91:622-5. [PMID: 10730108 PMCID: PMC1296979 DOI: 10.1177/014107689809101203] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Until a few decades ago, certain 'new-world' populations that kept to traditional dietary habits were virtually free from diabetes; then, after they began eating some foods that are common in Europe, the disease reached epidemic proportions. Europeans, by contrast, have a low rate of diabetes. To account for this paradox, it has been suggested that those new-world populations have a thrifty genotype, which would have conferred a selective advantage during the frequent famines of the past, while today it would be detrimental because the recently adopted foods are constantly available. Here it is proposed that thrifty genes are unlikely to exist. Both the diabetes epidemics that occur in newly westernized populations and the low rate of diabetes in Europeans can be explained by the hypothesis that Europeans, through millenary natural selection, have become adapted, albeit incompletely, to some diabetogenic foods for which humankind is genetically unequipped.
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Inoue H, Tanizawa Y, Wasson J, Behn P, Kalidas K, Bernal-Mizrachi E, Mueckler M, Marshall H, Donis-Keller H, Crock P, Rogers D, Mikuni M, Kumashiro H, Higashi K, Sobue G, Oka Y, Permutt MA. A gene encoding a transmembrane protein is mutated in patients with diabetes mellitus and optic atrophy (Wolfram syndrome). Nat Genet 1998; 20:143-8. [PMID: 9771706 DOI: 10.1038/2441] [Citation(s) in RCA: 525] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Wolfram syndrome (WFS; OMIM 222300) is an autosomal recessive neurodegenerative disorder defined by young-onset non-immune insulin-dependent diabetes mellitus and progressive optic atrophy. Linkage to markers on chromosome 4p was confirmed in five families. On the basis of meiotic recombinants and disease-associated haplotypes, the WFS gene was localized to a BAC/P1 contig of less than 250 kb. Mutations in a novel gene (WFS1) encoding a putative transmembrane protein were found in all affected individuals in six WFS families, and these mutations were associated with the disease phenotype. WFS1 appears to function in survival of islet beta-cells and neurons.
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Affiliation(s)
- H Inoue
- Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan
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