title: Association of endothelial nitric oxide synthase Glu298Asp, 4b/a, and -786T>C gene variants with diabetic nephropathy.
abstract: BACKGROUND
  Nitric oxide (NO) produced by endothelial NO synthase (eNOS) mediates a wide range of processes, and abnormal NO production mediated diabetes complications, including diabetic nephropathy (DN). In view of their impact on eNOS activity, polymorphisms in eNOS gene were described as candidates for atherosclerosis and DN.
  
  
  OBJECTIVE
  We evaluated the association of -786T>C (promoter region), Glu298Asp (Exon 7), and 4b4a (Intron 4) polymorphisms in eNOS gene with Type 2 diabetes mellitus (T2DM) and DN by haplotype analysis.
  
  
  METHODS
  Study subjects comprised 515 DN patients, 402 normoalbuminuric [diabetes with no nephropathy (DWN)] T2DM patients, and 748 healthy subjects. -786T>C and Glu298Asp genotyping were done by PCR-RFLP analysis.
  
  
  RESULTS
  Higher prevalence of mutant Asp298, 4a, and -786C alleles and homozygous Asp298/Asp298 and 4a/4a genotypes were seen in T2DM patients compared to healthy subjects, with increased Asp298/Asp298 seen in DN compared to DWN patients (P<.05). Three-loci haplotype analysis demonstrated significant association between eNOS variants and T2DM, with protective, neutral, T2DM, and DN-susceptible haplotypes identified, the latter including Asp298/4b/-786T and the Asp298/4a/-786C haplotypes that were present at higher frequencies among DN than among DWN patients. Multivariate regression analysis identified only Asp298/4a/-786T haplotype to be associated with DN (P=.047) after controlling for potential covariates.
  
  
  CONCLUSIONS
  Genetic variation at the eNOS locus is associated with T2DM. It can serve as a useful genetic marker of increased susceptibility to T2DM and its complications, including the risk of nephropathy.
authors.affiliation: Research Unit of Haematological and Autoimmune Diseases, Faculty of Pharmacy, Monastir, Center University, Tunisia.
authors.forename: Intissar
authors.initials: I
authors.lastname: Ezzidi
authors.forename: Nabil
authors.initials: N
authors.lastname: Mtiraoui
authors.forename: Manel Ben Hadj
authors.initials: MB
authors.lastname: Mohamed
authors.forename: Touhami
authors.initials: T
authors.lastname: Mahjoub
authors.forename: Maha
authors.initials: M
authors.lastname: Kacem
authors.forename: Wassim Y
authors.initials: WY
authors.lastname: Almawi
mesh_terms: D000368:Aged; D001224:Aspartic Acid / Q000235:genetics; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000235:genetics*; D003928:Diabetic Nephropathies / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D008040:Genetic Linkage; D020022:Genetic Predisposition to Disease; D005838:Genotype; D018698:Glutamic Acid / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D011110:Polymorphism, Genetic
chemical_list: D001224:Aspartic Acid; D018698:Glutamic Acid; D052250:Nitric Oxide Synthase Type III