Integrating Common Risk Factors with Polygenic Scores Improves the Prediction of Type 2 Diabetes

We tested associations between 13 established genetic variants and type 2 diabetes (T2D) in 1371 study participants from the Volga-Ural region of the Eurasian continent, and evaluated the predictive ability of the model containing polygenic scores for the variants associated with T2D in our dataset, alone and in combination with other risk factors such as age and sex. Using logistic regression analysis, we found associations with T2D for the CCL20 rs6749704 (OR = 1.68, P_FDR = 3.40 × 10^-5), CCR5 rs333 (OR = 1.99, P_FDR = 0.033), ADIPOQ rs17366743 (OR = 3.17, P_FDR = 2.64 × 10^-4), TCF7L2 rs114758349 (OR = 1.77, P_FDR = 9.37 × 10^-5), and CCL2 rs1024611 (OR = 1.38, P_FDR = 0.033) polymorphisms. We showed that the most informative prognostic model included weighted polygenic scores for these five loci, and non-genetic factors such as age and sex (AUC 85.8%, 95%CI 83.7-87.8%). Compared to the model containing only non-genetic parameters, adding the polygenic score for the five T2D-associated loci showed improved net reclassification (NRI = 37.62%, 1.39 × 10^-6). Inclusion of all 13 tested SNPs to the model with age and sex did not improve the predictive ability compared to the model containing five T2D-associated variants (NRI = -17.86, p = 0.093). The five variants associated with T2D in people from the Volga-Ural region are linked to inflammation (CCR5, CCL2, CCL20) and glucose metabolism regulation (TCF7L, ADIPOQ2). Further studies in independent groups of T2D patients should validate the prognostic value of the model and elucidate the molecular mechanisms of the disease development.

The use of drug based on technologically processed antibodies to endocannabinoid receptor type 1 in the treatment of obesity in adults: results of a multicenter double blind placebo controlled randomized clinical trial

Aim. To evaluate the clinical efficacy and safety of Dietressa at a dose of 6 tablets per day for 24 weeks in the treatment of patients with Class 1 obesity. To compare the clinical efficacy of two treatment regimens (1 tablet 6 times per day and 2 tablets 3 times per day) for 24 weeks in the treatment of patients with Class 1 obesity. Materials and methods. A clinical trial included 493 patients with Class 1 obesity from 18 to 65 years. The proportion of patients who lose greater than or equal to 5 percent of baseline body weight, an average decrease of body weight, a change in waist circumference, dynamics of the quality of life, and the safety of the therapy were assessed. Results. A weight decrease was established among patients without regard to the studied regimens of Dietressa (in a daily dose of 6 tablets with a six- or three-time intake). The goals were achieved by 49% [53%] of patients in the first treatment regimen (statistically significant compared to placebo therapy: p=0.04) [р=0.018]), 48% (51%) in the second (p=0.004 [р=0.0004]) and 48% [52%] of patients in the combined Dietressa group (p=0.0007 [р0.0001]). The average absolute weight loss was -4.44.2 [-4.84.2] kg in the Dietressa-1 group (p=0.0001 [р0.0001]) and -4.44.4 [-4.74.4] kg in the Dietressa-2 group (p0.0001) [р0.0001]). Against the background of the conducted therapy mental component was improved on week 4 (p0.0001) and 24 (p=0.006) as well as parameter of physical health on week 4 (p=0,003) and 12 (p=0,006). Waist circumference significantly decreased every 4 weeks in patients receiving Dietressa (p0.0001 for three comparisons between weeks). A 6-month course of Dietressa therapy demonstrated a favorable safety profile. The frequency of adverse events had no significant differences between Dietressa and Placebo groups. Conclusion. The monotherapy with Dietressa is safe, and it leads to at least 5 percent reduction in body weight during 24 weeks of therapy in patients with Class 1 obesity.

Multilocus associations of inflammatory genes with the risk of type 1 diabetes

BACKGROUND

Genome-wide association studies have captured a large proportion of genetic variation related to type 1 diabetes mellitus (T1D). However, most of these studies are performed in populations of European ancestry and therefore the disease risk estimations can be inaccurate when extrapolated to other world populations.

METHODS

We conducted a case-control study in 1866 individuals from the three major populations of the Republic of Bashkortostan (Russians, Tatars, and Bashkirs) in Russian Federation, using single-locus and multilocus approach to identify genetic predictors of T1D.

RESULTS

We found that LTA rs909253 and TNF rs1800629 polymorphisms were associated with T1D in the group of Tatars. Meta-analysis of the association study results in the three ethnic groups has confirmed the association between the T1D risk and LTA rs909253 genetic variant. LTA rs909253 and TNF rs1800629 loci were also featured in combinations most significantly associated with T1D.

CONCLUSION

Our findings suggest that LTA rs909253 and TNF rs1800629 polymorphisms are associated with the risk of T1D both independently and in combination with polymorphic markers in other inflammatory genes, and the analysis of multi-allelic combinations provides valuable insight in the study of polygenic traits.

[Association of adiponectin gene alleles with type 2 diabetes mellitus in residents of Bashkortostan]

Type 2 diabetes mellitus (T2DM) is one of the most acute problems of the modern world. The disease is characterized by high ratio of micro- and macrovascular complications. T2DM is a multifactorial and polygenic disease, structure of hereditary predisposition to which may be population-specific. Aim - the analysis of allelic associations of adiponectin gene (ADIPOQ, rs17366743) with T2DM, its clinical and metabolic characteristics and complications in T2DM patients resident in the Republic of Bashkortostan.

MATERIAL AND METHODS

3 PCR-based method of genotyping with polymorphic marker rs17366743 of ADIPOQ gene in 433 T2DM patients and 428 healthy controls, residents of Bashkortostan.

RESULTS

The ratio of genotype CT and allele С was higher in T2DM patients compared with controls (15.7% vs. 6.8%; p=0.0002 and 7.8% vs. 3.4%; p<0.0001, respectively). Genotype ТТ and allele Т were less frequent in T2DM than in healthy subjects (84.3 and 93,2%; p=0.0002; 92.2 and 96.6%, p<0.0001, respectively). The association with the development of diabetic retinopathy and cataract was shown (p=0,044, p=0,008, respectively).

CONCLUSIONS

Allele C and genotype CT are risk markers of T2DM (OR=2.43 and 2.56 respectively).

[Association of variable rs1801282 locus of PPARG2 gene with diabetic nephropathy]

The association of the variable rs1801282 locus of the PPARG2 gene (peroxisome proliferator-activated receptor gamma) with type 2 diabetes mellitus and its complications was analyzed in inhabitants of the Republic of Bashkortostan. The genotype frequencies of the variable rs1801282 locus of the PPARG2 gene did not significantly differ in groups of healthy persons and patients with type 2 diabetes in all three considered inheritance models (codominant, dominant, and recessive). At the same time, it was demonstrated that the risk of one of the diabetic complications, i.e., diabetic nephropathy, was associated with the variable rs1801282 locus of the PPARG2 gene. Diabetic nephropathy was more common in patients with the C/C genotype (62.7%) compared to the C/G and G/G genotypes (37.5%), P = 0.036. The G allele is protective in regard to diabetic nephropathy (OR = 0.36) in patients with type 2 diabetes mellitus.

[The effect of drugs on free-radical oxidation]

Data available in the literature and the results of original investigations of the effect of drugs on the free-radical oxidation process are summarized. It is pointed out that the character of drug influence on the on the free-radical oxidation process must be taken into account in selecting drugs for the treatment of particular diseases.

[Changes in the reaction to drug preparations in diabetes mellitus]

The article deals with information in the literature on the peculiarities of the response to drugs and the change of their pharmacokinetics in diabetes mellitus.

[The metabolic effects of isradipine, ramipril, Ednit and beta-adrenoblockers in patients with non-insulin-dependent diabetes mellitus and arterial hypertension]

The effect of isradepin, ramipril, ednyt, and beta-adrenoblockers on carbohydrate and lipid metabolism and free-radical oxidation in patients with insulin-independent diabetes mellitus was studied. Isradepin caused an increase in high-density lipoproteins (HDLP) in the blood serum and the content of esterified cholesterol in HDLP, and reduced the arterogenicity coefficient. Rampiril reduced the basal level of glycemia and insulin. Treatment with ednyt lead to increase in the content of HDLP and the content of free cholesterol in them. In the course of treatment isradepin normalized chemoluminescence of the serum and urine, rampiril that of serum, and beta-adrenoblockers the chemoluminescence of the blood. The favorable changes induced by the drugs under study allow them to be recommended for the treatment of arterial hypertension in patients with insulin-independent diabetes mellitus.

[The effect of antihypertensive preparations on carbohydrate metabolism in intact rats and in alloxan diabetes]

The metabolic affects of anapriline, captopril, and clophelin were studied in the blood and liver homogenates ex vivo and in vitro in experiments on intact rats and rats with alloxan diabetes. Anapriline lowered the blood lactate content in rats with diabetes and intact rats, reduced the level of glycemia in animals with marked hyperglycemia. Captopril increased the blood insulin and lactate content in rats with diabetes and the content of pyruvate in vivo. The results of the study show that the use of clophelin and anaprilin in the treatment of patients with diabetes mellitus is most rational.

[The oxidative metabolic systems of the liver in exposure to maninil and obzidan]

The effects of maninile and obsidan and their combined action on metabolic processes were studied in a series of in vitro experiments. The metabolic processes serve as a prerequisite to energy supply and couple the anabolic and catabolic pathways of hepatic metabolism. The rate of aerobic and anaerobic oxidation of glucose was shown to decrease when maninile was in close contact with liver tissue. It is indicative of the indirect hypoglycemic action of maninile. There is evidence for the combined use of maninile and obsidan since it allows the balance of regulatory metabolites to be maintained. Also, metabolic changes became less if they were used in combination rather alone.

[The effect of calcium antagonists on carbohydrate and lipid metabolism in diabetes mellitus]

The effect of calcium antagonists: nifedipine (corinfar, cordapheg), sensit, finoptin, foridon on carbohydrate and lipid metabolism was studied in intact and "alloxaned" rats as well as in non-insulin-dependent diabetes patients. It was found that the calcium channel blockers did not change glucose tolerance, normalized carbohydrate metabolism in some patients and decreased the level of triglycerides, B and pro-B lipoproteins. In some cases in intact and alloxane rats treated with finophin (isoptin), lactate decrease in blood and a tendency to insulin increase were often observed. The lipid metabolism was unchanged.

[Effectiveness of nonsteroidal antiphlogistics in experimental diabetes mellitus]

In experiments on rats with alloxan diabetes efficacy of amidopyrine, acetylsalicylic acid, methyluracil, butadione and brufen in experimental inflammation was shown. The antiinflammatory drugs under study were found to have various effects on insulin and glucose blood levels in intact rats and those with diabetes. The increase in glucose content under the influence of methyluracil is presumably connected with the elevation of somatotrophic hormone blood level. Acetylsalicylic acid and butadione reduce the content of somatotrophic hormone. Methyluracil potentiates antiexudative effects of acetylsalicylic acid and amidopyrine.