title: Diabetes mellitus, superoxide dismutase and peroxisome proliferator activated receptor gamma polymorphisms modify the outcome of end-stage renal disease patients of Han Chinese origin.
abstract: OBJECTIVE
  Increased oxidative stress significantly modifies the outcome of patients with diabetes mellitus (DM) and end-stage renal disease (ESRD), and is counteracted by antioxidative capacity. We aimed to investigate whether antioxidant single nucleotide polymorphisms (SNPs) influence the outcome of ESRD individuals and the influences exerted by DM, which has not been tested before.
  
  
  METHODS
  We prospectively enrolled multi-centre ESRD patients of Han Chinese origin between 2002 and 2003, recording their antioxidant (superoxide dismutase [SOD2], glutathione peroxidase [GPX1]) and peroxisome proliferator activated receptor-γ (PPAR-γ) genotyping results, and stratified based on DM. They were followed up until 2008, with risk factors for mortality analyzed by Cox proportional hazard regression.
  
  
  RESULTS
  We discovered that diabetic ESRD carriers of CC genotype of SOD2 exon 2 had an increased risk of mortality compared to non-diabetic ones with other genotypes (hazard ratio [HR] 4.04, P = 0.04), while GPX1 SNPs had no influence. Interactions between SOD2 and PPAR-γ SNPs regarding the mortality influence were also detected (for SOD2 CC genotype x PPAR-γ exon 6 CT genotype, HR 3.19, P = 0.008), suggesting the importance of considering a combination panel of SNPs on patient survival.
  
  
  CONCLUSIONS
  This might be the largest study focusing on the relationship between antioxidant SNPs and the outcomes of diabetic ESRD patients of Han Chinese origin. More studies are needed to validate our findings.
authors.affiliation: Department of Medicine, National Taiwan University Hospital Jinshan branch, New Taipei City, Taiwan.|Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan.|Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chia-Ter
authors.initials: CT
authors.lastname: Chao
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jenq-Wen
authors.initials: JW
authors.lastname: Huang
authors.affiliation: Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan.|Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yen-Ching
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Fang
authors.affiliation: Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Fu-Chang
authors.initials: FC
authors.lastname: Hu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chen-Chih
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Department of Geriatric Medicine and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Yen
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000235:genetics; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D003928:Diabetic Nephropathies / Q000208:ethnology / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D005091:Exons; D005260:Female; D005787:Gene Frequency; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D005979:Glutathione Peroxidase / Q000235:genetics; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D047495:PPAR gamma / Q000235:genetics*; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013482:Superoxide Dismutase / Q000235:genetics*; D013624:Taiwan / Q000453:epidemiology; D000094765:Glutathione Peroxidase GPX1; D000099156:Superoxide Dismutase 2
chemical_list: D005979:Glutathione Peroxidase; D047495:PPAR gamma; D013482:Superoxide Dismutase; D000094765:Glutathione Peroxidase GPX1; D000099156:Superoxide Dismutase 2; C000722067:GPX1 protein, human