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Ma RCW, So WY, Tam CHT, Luk AO, Ho JSK, Wang Y, Lam VK, Lee HM, Kong AP, Tong PC, Xu G, Chow CC, Ng MC, Yang XL, Chan JC. Genetic variants for type 2 diabetes and new-onset cancer in Chinese with type 2 diabetes. Diabetes Res Clin Pract 2014; 103:328-37. [PMID: 24468095 DOI: 10.1016/j.diabres.2013.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/24/2013] [Accepted: 12/18/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Diabetes is associated with an increased risk of cancer. This study aimed to evaluate associations between recently reported type 2 diabetes (T2D) susceptibility genetic variants and cancer risk in a prospective cohort of Chinese patients with T2D. METHODS Seven single nucleotide polymorphisms (SNP) in IGF2BP2, CDKAL1, SLC30A8, CDKN2A/B, HHEX and TCF7L2, all identified from genome-wide association studies of T2D, were genotyped in 5900 T2D patients [age mean ± SD = 57 ± 13 years, % males = 46] without any known cancer at baseline. Associations between new-onset of cancer and SNPs were tested by Cox proportional hazard models with adjustment of conventional risk factors. RESULTS During the mean follow-up period of 8.5 ± 3.3 years, 429 patients (7.3%) developed cancer. Of the T2D-related SNPs, the G-alleles of HHEX rs7923837 (hazard ratio [HR] (95% C.I.) = 1.34 (1.08-1.65); P = 6.7 ×10(-3) under dominant model) and TCF7L2 rs290481 (HR (95% C.I.) = 1.16 (1.01-1.33); P = 0.040 under additive model) were positively associated with cancer risk, while the G-allele of CDKAL1 rs7756992 was inversely associated (HR (95% C.I.) = 0.80 (0.65-1.00); P = 0.048 under recessive model). The risk alleles of these significant SNPs exhibited combined effect on increasing cancer risk (per-allele HR (95% C.I.) = 1.25 (1.12-1.39); P = 4.8 × 10(-5)). The adjusted cancer risk was 2.41 (95% C.I. 1.23-4.69) for patients with four risk alleles comparing to patients without risk allele. CONCLUSIONS T2D-related variants HHEX rs7923837, TCF7L2 rs290481 and CDKAL1 rs7756992 increased cancer risk in patients with diabetes. IMPACT Our findings provide novel insights into the pathogenesis of cancer in diabetes.
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Affiliation(s)
- R C W Ma
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong; Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong; Lee Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong.
| | - W Y So
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
| | - C H T Tam
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - A O Luk
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - J S K Ho
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Y Wang
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - V K Lam
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - H M Lee
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - A P Kong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - P C Tong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - G Xu
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong; Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong; Lee Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong
| | - C C Chow
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - M C Ng
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - X L Yang
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - J C Chan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong; Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong; Lee Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong
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Ma RCW, Hu C, Tam CH, Zhang R, Kwan P, Leung TF, Thomas GN, Go MJ, Hara K, Sim X, Ho JSK, Wang C, Li H, Lu L, Wang Y, Li JW, Wang Y, Lam VKL, Wang J, Yu W, Kim YJ, Ng DP, Fujita H, Panoutsopoulou K, Day-Williams AG, Lee HM, Ng ACW, Fang YJ, Kong APS, Jiang F, Ma X, Hou X, Tang S, Lu J, Yamauchi T, Tsui SKW, Woo J, Leung PC, Zhang X, Tang NLS, Sy HY, Liu J, Wong TY, Lee JY, Maeda S, Xu G, Cherny SS, Chan TF, Ng MCY, Xiang K, Morris AP, Keildson S, Hu R, Ji L, Lin X, Cho YS, Kadowaki T, Tai ES, Zeggini E, McCarthy MI, Hon KL, Baum L, Tomlinson B, So WY, Bao Y, Chan JCN, Jia W. Genome-wide association study in a Chinese population identifies a susceptibility locus for type 2 diabetes at 7q32 near PAX4. Diabetologia 2013; 56:1291-305. [PMID: 23532257 PMCID: PMC3648687 DOI: 10.1007/s00125-013-2874-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 01/31/2013] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS Most genetic variants identified for type 2 diabetes have been discovered in European populations. We performed genome-wide association studies (GWAS) in a Chinese population with the aim of identifying novel variants for type 2 diabetes in Asians. METHODS We performed a meta-analysis of three GWAS comprising 684 patients with type 2 diabetes and 955 controls of Southern Han Chinese descent. We followed up the top signals in two independent Southern Han Chinese cohorts (totalling 10,383 cases and 6,974 controls), and performed in silico replication in multiple populations. RESULTS We identified CDKN2A/B and four novel type 2 diabetes association signals with p < 1 × 10(-5) from the meta-analysis. Thirteen variants within these four loci were followed up in two independent Chinese cohorts, and rs10229583 at 7q32 was found to be associated with type 2 diabetes in a combined analysis of 11,067 cases and 7,929 controls (p meta = 2.6 × 10(-8); OR [95% CI] 1.18 [1.11, 1.25]). In silico replication revealed consistent associations across multiethnic groups, including five East Asian populations (p meta = 2.3 × 10(-10)) and a population of European descent (p = 8.6 × 10(-3)). The rs10229583 risk variant was associated with elevated fasting plasma glucose, impaired beta cell function in controls, and an earlier age at diagnosis for the cases. The novel variant lies within an islet-selective cluster of open regulatory elements. There was significant heterogeneity of effect between Han Chinese and individuals of European descent, Malaysians and Indians. CONCLUSIONS/INTERPRETATION Our study identifies rs10229583 near PAX4 as a novel locus for type 2 diabetes in Chinese and other populations and provides new insights into the pathogenesis of type 2 diabetes.
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Affiliation(s)
- R. C. W. Ma
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
- Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
- Li Ka Shing Institute of Life Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - C. Hu
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital South Campus, Shanghai, People’s Republic of China
| | - C. H. Tam
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - R. Zhang
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - P. Kwan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - T. F. Leung
- Department of Paediatrics, Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - G. N. Thomas
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - M. J. Go
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Gangoe-myeon, Yeonje-ri, Cheongwon-gun, Chungcheongbuk-do Republic of Korea
| | - K. Hara
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- Department of Integrated Molecular Science on Metabolic Diseases, University of Tokyo Hospital, Tokyo, Japan
| | - X. Sim
- Centre for Molecular Epidemiology, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI USA
| | - J. S. K. Ho
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - C. Wang
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - H. Li
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, People’s Republic of China
| | - L. Lu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, People’s Republic of China
| | - Y. Wang
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, People’s Republic of China
| | - J. W. Li
- School of Life Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - Y. Wang
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - V. K. L. Lam
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - J. Wang
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - W. Yu
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - Y. J. Kim
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Gangoe-myeon, Yeonje-ri, Cheongwon-gun, Chungcheongbuk-do Republic of Korea
| | - D. P. Ng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - H. Fujita
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K. Panoutsopoulou
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - A. G. Day-Williams
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - H. M. Lee
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - A. C. W. Ng
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - Y-J. Fang
- Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China
| | - A. P. S. Kong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - F. Jiang
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - X. Ma
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - X. Hou
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - S. Tang
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - J. Lu
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - T. Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - S. K. W. Tsui
- School of Biomedical Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - J. Woo
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - P. C. Leung
- Department of Orthopaedics, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - X. Zhang
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital South Campus, Shanghai, People’s Republic of China
| | - N. L. S. Tang
- Department of Chemical Pathology, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - H. Y. Sy
- Department of Paediatrics, Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - J. Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Republic of Singapore
| | - T. Y. Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, VIC Australia
| | - J. Y. Lee
- Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Gangoe-myeon, Yeonje-ri, Cheongwon-gun, Chungcheongbuk-do Republic of Korea
| | - S. Maeda
- Laboratory for Endocrinology and Metabolism, RIKEN Center for Genomic Medicine, Yokohama, Japan
| | - G. Xu
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - S. S. Cherny
- Department of Psychiatry and State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - T. F. Chan
- School of Life Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - M. C. Y. Ng
- Center for Genomics and Personalized Medicine Research, Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - K. Xiang
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - A. P. Morris
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - S. Keildson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - R. Hu
- Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China
| | - L. Ji
- Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - X. Lin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, People’s Republic of China
| | - Y. S. Cho
- Department of Biomedical Science, Hallym University, Chuncheon, Gangwon-do Republic of Korea
| | - T. Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - E. S. Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Graduate Medical School, Duke-National University of Singapore, Singapore, Republic of Singapore
| | - E. Zeggini
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - M. I. McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - K. L. Hon
- Department of Paediatrics, Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - L. Baum
- School of Pharmacy, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - B. Tomlinson
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - W. Y. So
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
| | - Y. Bao
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
| | - J. C. N. Chan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR People’s Republic of China
- Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
- Li Ka Shing Institute of Life Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - W. Jia
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233 People’s Republic of China
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