title: Association between the A-2518G polymorphism in the monocyte chemoattractant protein-1 gene and insulin resistance and Type 2 diabetes mellitus.
abstract: OBJECTIVE
  The molecular mechanisms of obesity-related insulin resistance are incompletely understood. Macrophages accumulate in adipose tissue of obese individuals. In obesity, monocyte chemoattractant protein-1 (MCP-1), a key chemokine in the process of macrophage accumulation, is overexpressed in adipose tissue. MCP-1 is an insulin-responsive gene that continues to respond to exogenous insulin in insulin-resistant adipocytes and mice. MCP-1 decreases insulin-stimulated glucose uptake into adipocytes. The A-2518G polymorphism in the distal regulatory region of MCP-1 may regulate gene expression. The aim of this study was to investigate the impact of this gene polymorphism on insulin resistance.
  
  
  METHODS
  We genotyped the Ludwigshafen Risk and Cardiovascular Health (LURIC) cohort ( n=3307). Insulin resistance, estimated by homeostasis model assessment, and Type 2 diabetes were diagnosed in 803 and 635 patients respectively.
  
  
  RESULTS
  Univariate analysis revealed that plasma MCP-1 levels were significantly and positively correlated with WHR ( p=0.011), insulin resistance ( p=0.0097) and diabetes ( p<0.0001). Presence of the MCP-1 G-2518 allele was associated with decreased plasma MCP-1 ( p=0.017), a decreased prevalence of insulin resistance (odds ratio [OR]=0.82, 95% CI: 0.70-0.97, p=0.021) and a decreased prevalence of diabetes (OR=0.80, 95% CI: 0.67-0.96, p=0.014). In multivariate analysis, the G allele retained statistical significance as a negative predictor of insulin resistance (OR=0.78, 95% CI: 0.65-0.93, p=0.0060) and diabetes (OR=0.80, 95% CI: 0.66-0.96, p=0.018).
  
  
  CONCLUSIONS
  In a large cohort of Caucasians, the MCP-1 G-2518 gene variant was significantly and negatively correlated with plasma MCP-1 levels and the prevalence of insulin resistance and Type 2 diabetes. These results add to recent evidence supporting a role for MCP-1 in pathologies associated with hyperinsulinaemia.
authors.affiliation: Department of Cardiology, University Hospital, CHUV-BH10, 1011, Lausanne, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Simeoni
authors.forename: M M
authors.initials: MM
authors.lastname: Hoffmann
authors.forename: B R
authors.initials: BR
authors.lastname: Winkelmann
authors.forename: J
authors.initials: J
authors.lastname: Ruiz
authors.forename: S
authors.initials: S
authors.lastname: Fleury
authors.forename: B O
authors.initials: BO
authors.lastname: Boehm
authors.forename: W
authors.initials: W
authors.lastname: März
authors.forename: G
authors.initials: G
authors.lastname: Vassalli
mesh_terms: D000225:Adenine; D000368:Aged; D018932:Chemokine CCL2 / Q000235:genetics*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000235:genetics*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006147:Guanine; D006706:Homeostasis; D006801:Humans; D006946:Hyperinsulinism / Q000235:genetics; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D006147:Guanine; D005947:Glucose; D000225:Adenine