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BMC Medicine

, 4:34

First Online: 20 December 2006Received: 23 August 2006Accepted: 20 December 2006DOI: 10.1186-1741-7015-4-34

Cite this article as: Melzer, D., Murray, A., Hurst, A.J. et al. BMC Med 2006 4: 34. doi:10.1186-1741-7015-4-34

Abstract

BackgroundA polymorphism in the transcription factor 7-like 2 TCF7L2 gene has been found to be associated with type 2 diabetes in case-control studies. We aimed to estimate associations of the marker rs7903146 C-T polymorphism with fasting glucose, lipids, diabetes prevalence and complications in an older general population.

MethodsIn total, 944 subjects aged ≥ 65 years from the population representative InCHIANTI study were enrolled in this study. Those with fasting blood glucose of ≥ 7 mmol-l or physician diagnosis were considered diabetic. Cut-off points for impaired fasting glucose IFG were ≥ 5.6 mmol-l to < 7 mmol-l.

ResultsIn the general population sample, minor T allele carriers of rs7903146 had higher fasting blood glucose FBG p = 0.028 but lower fasting insulin p = 0.030 and HOMA2b scores p = 0.001, suggesting poorer beta-cell function. T allele carriers also had smaller waist circumference p = 0.009, lower triglyceride levels p = 0.006, and higher high-density lipoprotein cholesterol p = 0.008.

The prevalence of diabetes or IFG was 32.4% in TT carriers and 23.3% in CC carriers; adjusted OR = 1.67 95% confidence interval 1.05 to 2.65, p = 0.031. Within the diabetic and IFG groups, fewer T allele carriers had metabolic syndrome features p = 0.047 or had experienced a myocardial infarction p = 0.037. Conversely, T allele carriers with diabetes had poorer renal function reduced 24-hour creatinine clearance, p = 0.013, and possibly more retinopathy p = 0.067. Physician-diagnosed dementia was more common in the T carriers in diabetes p = 0.05, with IFG p = 0.024.

ConclusionThe TCF7L2 rs7903146 polymorphism is associated with lower insulin levels, smaller waist circumference, and lower risk lipid profiles in the general elderly population. Patients with diabetes who are carriers of the minor allele are less likely to have metabolic-syndrome features, but may experience more microvascular complications, although the number of cases was small. If replicated, these findings may have implications for developing treatment approaches tailored by genotype.

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Autor: David Melzer - Anna Murray - Alison J Hurst - Michael N Weedon - Stefania Bandinelli - Anna Maria Corsi - Luigi Ferrucci

Fuente: https://link.springer.com/







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