[Effect of the Gly972Arg, SNP43 and Prol2Ala polymorphisms of the genes IRS1, CAPN10 and PPARG2 on secondary failure to sulphonylurea and metformin in patients with type 2 diabetes in Yucatán, México].
In Yucatán, 52% of patients with type 2 diabetes (DT2) present secondary failure to treatment associated with sulphonylurea and metformin. A possible explanation may be due to polymorphisms in the genes IRS1, CAPN10, PPARG2, which are involved in pancreatic beta cell dysfunction and a poor response to the action of insulin. The association of the polymorphisms Gly972Arg, SNP43, and Pro12Ala, of the genes IRS1, CAPN10, PPARG2, with the risk of failure to sulphonylurea and metformin therapies was determinated in patients with DT2 in Yucatán, México. One hundred and thirty and two subjects with DT2 were classified in groups of responders (HbA1c < 8%) and non-responders (HbA1c > 8%) to the treatment, according to the control of hyperglucemia with sulphonylurea and metformin. Demographic, anthropometric and metabolic data were obtained from each subject. The polymorphisms were identified by means of DNA analysis by PCR/RFLP and PCR/OAL. Genotypic and allelic frequencies and the Hardy-Weinberg equilibrium were determined. Statistical analyses consisted of X2 and multiple logistic regression tests (Epi-Info 2000 and SPSS version 12). Obese subjects carrying the genotype AA SNP43 showed 4.69 times more risk of failure to respond to treatment (p = 0.027), when compared with subjects sharing GA genotype: X2 (OR = 4.69, IC: 1.15-20.59) and multiple logistic regression, p = 0.048, (OR = 3.72, IC: 1.009-13.718). The interaction between genotype AA and the BMI > 27 showed also a significant difference (p = 0.009). The findings suggest the fact that polymorphism SNP43 may influence the response to treatment with sulphonylurea and metformin, the expression being dependent on obesity.
García-Escalante
María Guadalupe
MG
Departamento de Salud Reproductiva y Genética, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, México. gescalan@uady.mx
Suárez-Solís
Víctor Manuel
VM
López-Avila
María Teresa de Jesús
MT
Pinto-Escalante
Doris del Carmen
Ddel C
Laviada-Molina
Hugo
H
D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D002154:Calpain / Q000235:genetics* / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000235:genetics*; D004351:Drug Resistance / Q000235:genetics*; D005260:Female; D005838:Genotype; D006442:Glycated Hemoglobin / Q000032:analysis; D006239:Haplotypes / Q000235:genetics; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D055504:Insulin Receptor Substrate Proteins / Q000235:genetics* / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D008687:Metformin / Q000494:pharmacology* / Q000627:therapeutic use; D008800:Mexico; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000235:genetics; D047495:PPAR gamma / Q000235:genetics* / Q000502:physiology; D020641:Polymorphism, Single Nucleotide; D012306:Risk; D013453:Sulfonylurea Compounds / Q000494:pharmacology* / Q000627:therapeutic use
D002154:Calpain; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D055504:Insulin Receptor Substrate Proteins; D008055:Lipids; D008687:Metformin; D047495:PPAR gamma; D013453:Sulfonylurea Compounds; C526292:IRS1 protein, human; C415197:calpain 10