Paré Guillaume, Chasman Daniel I, Parker Alexander N, Nathan David M, Miletich Joseph P, Zee Robert Y, Ridker Paul M
Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
PLoS Genet. 2008 Dec;4(12):e1000312. doi: 10.1371/journal.pgen.1000312. Epub 2008 Dec 19.
Type 2 diabetes is a leading cause of morbidity and mortality. While genetic variants have been found to influence the risk of type 2 diabetes mellitus, relatively few studies have focused on genes associated with glycated hemoglobin, an index of the mean blood glucose concentration of the preceding 8-12 weeks. Epidemiologic studies and randomized clinical trials have documented the relationship between glycated hemoglobin levels and the development of long-term complications in diabetes; moreover, higher glycated hemoglobin levels in the subdiabetic range have been shown to predict type 2 diabetes risk and cardiovascular disease. To examine the common genetic determinants of glycated hemoglobin levels, we performed a genome-wide association study that evaluated 337,343 SNPs in 14,618 apparently healthy Caucasian women. The results show that glycated hemoglobin levels are associated with genetic variation at the GCK (rs730497; P = 2.8 x 10(-12)), SLC30A8 (rs13266634; P = 9.8 x 10(-8)), G6PC2 (rs1402837; P = 6.8 x 10(-10)), and HK1 (rs7072268; P = 6.4 x 10(-9)) loci. While associations at the GCK, SLC30A8, and G6PC2 loci are confirmatory, the findings at HK1 are novel. We were able to replicate this novel association in an independent validation sample of 455 additional non-diabetic men and women. HK1 encodes the enzyme hexokinase, the first step in glycolysis and a likely candidate for the control of glucose metabolism. This observed genetic association between glycated hemoglobin levels and HK1 polymorphisms paves the way for further studies of the role of HK1 in hemoglobin glycation, glucose metabolism, and diabetes.
2型糖尿病是发病和死亡的主要原因。虽然已发现基因变异会影响2型糖尿病的风险,但相对较少的研究关注与糖化血红蛋白相关的基因,糖化血红蛋白是前8至12周平均血糖浓度的指标。流行病学研究和随机临床试验记录了糖化血红蛋白水平与糖尿病长期并发症发生之间的关系;此外,亚糖尿病范围内较高的糖化血红蛋白水平已被证明可预测2型糖尿病风险和心血管疾病。为了研究糖化血红蛋白水平的常见遗传决定因素,我们进行了一项全基因组关联研究,评估了14618名表面健康的白人女性中的337343个单核苷酸多态性(SNP)。结果显示,糖化血红蛋白水平与GCK(rs730497;P = 2.8×10⁻¹²)、SLC30A8(rs13266634;P = 9.8×10⁻⁸)、G6PC2(rs1402837;P = 6.8×10⁻¹⁰)和HK1(rs7072268;P = 6.4×10⁻⁹)基因座的基因变异相关。虽然GCK、SLC30A8和G6PC2基因座的关联是得到证实的,但HK1基因座的发现是新的。我们能够在另外455名非糖尿病男性和女性的独立验证样本中复制这一新的关联。HK1编码己糖激酶,这是糖酵解的第一步,可能是控制葡萄糖代谢的候选基因。观察到的糖化血红蛋白水平与HK1多态性之间的遗传关联为进一步研究HK1在血红蛋白糖化、葡萄糖代谢和糖尿病中的作用铺平了道路。