Hölzl B, Iglseder B, Stadlmayr A, Hedegger M, Moré E, Reiter R, Sandhofer F, Paulweber B
1st Department Int. Medical, St. Johanns Spital, Salzburg, Austria.
Eur J Clin Invest. 2003 Feb;33(2):110-6. doi: 10.1046/j.1365-2362.2003.01113.x.
The Gly972Arg mutation in the IRS-1 gene has been found to be associated with insulin resistance and type II diabetes. A recently published study described an association between the Arg allele and an increased risk for coronary artery disease. In the present study we asked whether the presence of the codon 972 mutation in the IRS-1 gene is associated with higher IMT values of the carotid arteries.
To address this question, genotypes of the codon 972 polymorphism were determined in 1018 healthy unrelated individuals aged 40-65 years. Three homozygous carriers of the mutation were excluded for statistical analysis. In all subjects, intima media thickness (IMT) and B-scores of carotid arteries as well as a large number of metabolic parameters were determined.
Heterozygous carriers of the Arg972 allele exhibited significantly lower IMT and B-score values than noncarriers. Total cholesterol, LDL-cholesterol and serum levels of apolipoprotein B were significantly lower in the carriers. Furthermore, a significant interaction between Gly972Arg-carrier status and mean daytime 24-h systolic blood pressure with regard to IMT could be observed; carriers with a systolic blood pressure above the median had lower IMT values than carriers with a systolic blood pressure equal or below the median. All these effects were more pronounced in females and remained significant after adjustment for sex, age, BMI, systolic blood pressure and serum apolipoprotein B levels. No significant differences between the carriers and the noncarriers could be found for BMI, insulin sensitivity or frequency of type II diabetes.
The results of our study demonstrate that the presence of the Arg972 allele is associated with lower IMT values of the carotid arteries. This finding is partly explained by lower serum levels of apolipoprotein B in carriers. The protective effect of the Gly972 Arg mutation seems to be stronger in the presence of a higher systolic blood pressure. Our data contradict previous findings suggesting an increased risk for insulin resistance, type II diabetes and atherosclerotic vascular disease in carriers of the mutation.
已发现胰岛素受体底物-1(IRS-1)基因中的Gly972Arg突变与胰岛素抵抗及II型糖尿病有关。最近发表的一项研究描述了Arg等位基因与冠状动脉疾病风险增加之间的关联。在本研究中,我们探讨了IRS-1基因中密码子972突变的存在是否与颈动脉内膜中层厚度(IMT)值升高有关。
为解决这个问题,我们在1018名年龄在40至65岁的健康无关个体中确定了密码子972多态性的基因型。三名该突变的纯合携带者被排除在统计分析之外。在所有受试者中,测定了颈动脉的内膜中层厚度(IMT)和B值以及大量代谢参数。
Arg972等位基因的杂合携带者的IMT和B值显著低于非携带者。携带者的总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B的血清水平显著较低。此外,可观察到Gly972Arg携带者状态与日间24小时平均收缩压在IMT方面存在显著相互作用;收缩压高于中位数的携带者的IMT值低于收缩压等于或低于中位数的携带者。所有这些效应在女性中更为明显,在对性别、年龄、体重指数、收缩压和血清载脂蛋白B水平进行调整后仍具有显著性。在携带者和非携带者之间,体重指数、胰岛素敏感性或II型糖尿病的发生率没有显著差异。
我们的研究结果表明,Arg972等位基因的存在与颈动脉较低的IMT值有关。这一发现部分可由携带者较低的载脂蛋白B血清水平来解释。Gly972Arg突变的保护作用在收缩压较高时似乎更强。我们的数据与之前关于该突变携带者胰岛素抵抗、II型糖尿病和动脉粥样硬化性血管疾病风险增加的研究结果相矛盾。