Genetic variants associated with insulin resistance and metabolic syndrome in young Asian Indians with myocardial infarction.
BACKGROUND
The objective of this study was to assess whether an association exists between the metabolic syndrome and polymorphisms in genes involved in insulin resistance in young Asian Indian patients presenting with acute myocardial infarction (AMI).


METHODS
The study population comprised 467 patients who were 45 years or younger. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the International Diabetes Federation (IDF) definitions were used to assess the prevalence of metabolic syndrome. We examined the genotype and allele frequencies of the IRS-I G972R, PPAR-gamma P12A, KCNJ11 E23K, and TNF-alpha -308G/A polymorphisms in relation to the metabolic syndrome determined by both definitions.


RESULTS
The metabolic syndrome as defined by the NCEP ATP III criteria was found in 282 (60.4%) patients, and in 278 (59.5%) patients according to the IDF criteria. This gave only a moderate level of agreement of 79% between the two definitions (Cohen's kappa = 0.554). No association was found between the IRS-I G972R, PPAR-gamma P12A, and KCNJ11 E23K, or TNF-alpha -308G/A polymorphic variants and the metabolic syndrome, or its components, for either definition.


CONCLUSIONS
Although the metabolic syndrome is a common finding in young Asian Indian patients with AMI, there was only a moderate level of agreement between the NCEP ATP III and IDF definitions of the syndrome. Our findings do not support a role for any of the polymorphic variant alleles in the four insulin resistance-related genes examined in the etiology of insulin resistance and reinforces the notion of a multifactorial etiology for the metabolic syndrome.
Ranjith
Naresh
N
Departments of Medicine, Coronary Care Unit, R.K. Khan Hospital, Durban, South Africa. ranjith@lantic.co.za
Pegoraro
Rosemary J
RJ
Naidoo
Datshana P
DP
Shanmugam
Rebecca
R
Rom
Lee
L
D000328:Adult; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D055504:Insulin Receptor Substrate Proteins / Q000235:genetics; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000235:genetics*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000235:genetics*; D047495:PPAR gamma / Q000235:genetics; D011110:Polymorphism, Genetic; D024661:Potassium Channels, Inwardly Rectifying / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics; D000099161:Kcnj11 Channel
D055504:Insulin Receptor Substrate Proteins; D047495:PPAR gamma; D024661:Potassium Channels, Inwardly Rectifying; D014409:Tumor Necrosis Factor-alpha; D000099161:Kcnj11 Channel; C526292:IRS1 protein, human