Polymorphism of Transcription Factor-7-Like 2 (TCF7L2) Gene and New-Onset Diabetes after Liver Transplantation.
BACKGROUND
New-onset diabetes after transplantation (NODAT) is a serious complication in transplant recipients. Transcription factor-7-like 2 (TCF7L2) is a Wnt signaling-associated transcription factor that plays an important role in β-cell proliferation and insulin secretion. The association between TCF7L2 SNP rs7903146 and NODAT was documented in renal transplant patients.


OBJECTIVE
To determine the association between TCF7L2 rs7903146 variants and the risk of NODAT after liver transplantation.


METHODS
This study was conducted on 140 liver transplant recipients who had received tacrolimus-based immunosuppressive drugs. The patients were divided into NODAT (n=70) and non-NODAT (n=70) groups and were genotyped using PCR-RFLP. In addition, 100 normal subjects were considered as the comparison group.


RESULTS
There was a significant difference (p<0.05) between the two study groups regarding donor and recipient age, recipient body mass index, and recipient fasting plasma glucose before the transplantation. No significant relationship was observed between TCF7L2 rs7903146 genotypes and development of NODAT. No significant difference was also found between the two groups in terms of the tacrolimus and mycophenolate mofetil daily dosage as well as tacrolimus blood level. However, the prednisolone daily dosage was significantly (p=0.01) higher in the NODAT group compared to those without NODAT. The majority of the patients in the NODAT group also had an episode of acute rejection. Furthermore, a significant difference was found between the transplant recipients and the comparison subjects regarding T allele (p<0.001, OR=1.96) and TT genotype (p<0.001, OR=3.47) frequencies.


CONCLUSIONS
No correlation was found between TCF7L2 genotypes and development of NODAT. Acute rejection and prednisolone pulse therapy predisposed the susceptible patients to NODAT.
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Genetic, Sistan and Baluchestan University of Sciences, Zahedan, Iran.
Z
Z
Musavi
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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N
Azarpira
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Genetic, Sistan and Baluchestan University of Sciences, Zahedan, Iran.
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MH
Sangtarash
Department of Genetic, Sistan and Baluchestan University of Sciences, Zahedan, Iran.
M
M
Kordi
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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K
Kazemi
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
B
B
Geramizadeh
Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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SA
Malek-Hosseini
Diabetes mellitus; Liver transplantation; Polymorphism; Transcription factor 7-like 2 protein; Transcription factors; genetic