CDK5 Regulatory Subunit-Associated Protein 1-Like 1 Gene Polymorphisms and Gestational Diabetes Mellitus Risk: A Trial Sequential Meta-Analysis of 13,306 Subjects

Mechanisms and Physiological Roles of Polymorphisms in Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is a significant pregnancy complication linked to perinatal complications and an elevated risk of future metabolic disorders for both mothers and their children. GDM is diagnosed when women without prior diabetes develop chronic hyperglycemia due to β-cell dysfunction during gestation. Global research focuses on the association between GDM and single nucleotide polymorphisms (SNPs) and aims to enhance our understanding of GDM's pathogenesis, predict its risk, and guide patient management. This review offers a summary of various SNPs linked to a heightened risk of GDM and explores their biological mechanisms within the tissues implicated in the development of the condition.

Genetic variants of ERBB4 gene and risk of gestational diabetes mellitus: a susceptibility and diagnostic nomogram study

Introduction

Gestational diabetes (GDM) is one of the common complications of female pregnancy, which seriously affects the health of mothers and their offspring. So far, the etiology has not been fully clarified.

Methods

A case-control study was conducted to clarify the relationship between Erb-b2 receptor tyrosine kinase 4 (ERBB4) functional tag genetic variants (rs1595064, rs1595065, rs1595066 and rs6719645) and the risk of GDM. Associations between variants and GDM risk were evaluated with the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Subsequently, the false-positive reporting probability (FPRP), multi-factor dimension reduction (MDR) and bioinformatics analysis were adopted to confirm the significant associations. A nomogram model was constructed to predict the risk of GDM.

Results

Association analysis demonstrated that rs1595066 TT genotype performed a protective effect on GDM risk among all subjects (TT vs. CC: adjusted OR = 0.60, 95% CI = 0.38 - 0.94, P = 0.026; TT vs. CC/CT: adjusted OR = 0.61, 95% CI = 0.40 - 0.95, P = 0.027). Meanwhile, stratified analysis showed that rs1595066 TT can also reduce the GDM risk in age > 30.09 years old, pre-pregnancy BMI > 22.23 Kg/m2, SBP ≤ 110.08 mmHg, etc subgroups. Interactions between rs1595066 and DBP (P interaction = 0.01), FPG (P interaction < 0.001) and HbA1c (P interaction < 0.001) were detected. The FPRP analysis confirmed that association between rs1595066 and GDM risk in subjects of FPG < 4.79 mmol/L (P = 0.199) is true. The MDR analysis showed that rs1595066 was the best single locus model while the 4-loci model was the best multiple factors model to predict GDM risk. Functional prediction revealed that rs1595066 may disturb the stability of miRNA-mRNA binding. The predictive nomogram model has a well consistence and acceptable discriminative ability with a diagnosed AUC of 0.813.

Discussion

ERBB4 variants can change an individual's susceptibility to GDM via the interaction of gene-gene, gene-environment and changes in the regulatory effects of miRNAs on ERBB4 expression.

TFP5 attenuates cyclin-dependent kinase 5-mediated islet β-cell damage in diabetes

Islet β-cell damage and dysfunction represent the pathophysiological basis of diabetes. Excessive activation of cyclin-dependent kinase 5 (CDK5) is involved in the pathogenesis of type 2 diabetes mellitus (T2DM), although the exact mechanism remains unclear. Therefore, this study investigated the role of a CDK5 inhibitor (TFP5) in islet β-cell damage under diabetic conditions by regulating the expression of CDK5 in vitro and in vivo. CDK5 was upregulated under high glucose conditions in vivo and in vitro, which resulted in inflammation, oxidative stress, and apoptosis of islet β-cells, thereby decreasing insulin secretion. However, TFP5 treatment inhibited the overexpression of CDK5; reduced the inflammatory response, oxidative stress, and apoptosis of islet β cells; and restored insulin secretion. In conclusion, CDK5 is involved in islet β-cell damage under high glucose conditions, and TFP5 may represent a promising candidate for the development of treatments for T2DM.

Association of the CDKAL1 gene polymorphism with gestational diabetes mellitus in Chinese women

INTRODUCTION

To identify the association of the cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1 (CDKAL1) gene polymorphism with gestational diabetes mellitus (GDM) in the Chinese population.

RESEARCH DESIGN AND METHODS

This case-control study enrolled 835 pregnant women with GDM and 870 pregnant women without diabetes who underwent antenatal examination during 24 to 28 gestational weeks at the Maternal and Child Health Hospital of Hubei Province from January 15, 2018 to March 31, 2019. Trained nurses collected their clinical information and blood samples. CDKAL1 gene rs10440833, rs10946398, rs4712523, rs4712524, rs7754840, rs7756992 and rs9465871 loci were genotyped by Agena MassARRAY system. SPSS V.26.0 software and online SHesis were used to analyze the relationship between CDKAL1 gene polymorphism and GDM susceptibility.

RESULTS

After being adjusted for maternal age, prepregnancy body mass index (BMI), parity and family history of type 2 diabetes mellitus (T2DM), CDKAL1 gene rs10440833 (AA vs TT, OR=1.631, 95% CI 1.192 to 2.232), rs10946398 (CC vs AA, OR=1.400, 95% CI 1.028 to 1.905), rs4712523 (GG vs AA, OR=1.409, 95% CI 1.038 to 1.913), rs4712524 (GG vs AA, OR=1.418, 95% CI 1.043 to 1.929) and rs7754840 (CC vs GG, OR=1.407, 95% CI 1.036 to 1.911) polymorphisms were all associated with the increased risk of GDM. In addition, there was a powerful linkage disequilibrium (LD) among rs10946398, rs4712523, rs4712524 and rs7754840 (D'>0.900, r²>0.900). And there were significant differences in haplotype CGGC (OR=1.207, 95% CI 1.050 to 1.387) and AAAG (OR=0.829, 95% CI 0.721 o 0.952, p=0.008) between the GDM group and the control group.

CONCLUSIONS

rs10440833, rs10946398, rs4712523, rs4712524 and rs7754840 of CDKAL1 gene are associated with GDM susceptibility in central Chinese population.

Mouse Models of Gestational Diabetes Mellitus and Its Subtypes: Recent Insights and Pitfalls

Gestational diabetes mellitus (GDM) is currently the most common complication of pregnancy and is defined as a glucose intolerance disorder with recognition during pregnancy. GDM is considered a uniform group of patients in conventional guidelines. In recent years, evidence of the disease's heterogeneity has led to a growing understanding of the value of dividing patients into different subpopulations. Furthermore, in view of the increasing incidence of hyperglycemia outside pregnancy, it is likely that many cases diagnosed as GDM are in fact patients with undiagnosed pre-pregnancy impaired glucose tolerance (IGT). Experimental models contribute significantly to the understanding of the pathogenesis of GDM and numerous animal models have been described in the literature. The aim of this review is to provide an overview of the existing mouse models of GDM, in particular those that have been obtained by genetic manipulation. However, these commonly used models have certain limitations in the study of the pathogenesis of GDM and cannot fully describe the heterogeneous spectrum of this polygenic disease. The polygenic New Zealand obese (NZO) mouse is introduced as a recently emerged model of a subpopulation of GDM. Although this strain lacks conventional GDM, it exhibits prediabetes and an IGT both preconceptionally and during gestation. In addition, it should be emphasized that the choice of an appropriate control strain is of great importance in metabolic studies. The commonly used control strain C57BL/6N, which exhibits IGT during gestation, is discussed in this review as a potential model of GDM.