Meyer Silke, Schaefer Stephan, Ivan Diana, Stolk Lisette, Arp Pascal, Uitterlinden André G, Nawroth Peter P, Plöckinger Ursula, Stalla Günter K, Tuschy Ulrich, Weber Matthias M, Weise Alexander, Pfützner Andreas, Kann Peter H
Division of Endocrinology & Diabetology, University Hospital Giessen and Marburg GmbH, Philipps-University Marburg, Baldingerstrasse, 35033 Marburg, Germany.
Pharmacogenomics. 2009 Feb;10(2):293-302. doi: 10.2217/14622416.10.2.293.
Several SNPs and a microsatellite cytosine-adenine repeat promoter polymorphism of the IGF-1 gene have been reported to be associated with circulating IGF-1 serum concentrations. Variance in IGF-1 concentrations due to genetic variations may affect different response to growth hormone (GH) treatment, resulting in different individually required GH-doses in GH-deficient patients. The aim of this study was to test if the IGF-1 gene polymorphisms are associated with the GH-dose of GH-deficient adults.
MATERIALS & METHODS: A total of nine tagging SNPs, five additionally selected SNPs and a cytosine-adenine repeat polymorphism were determined in 133 German adult patients (66 men, 67 women; mean age 45.4 years +/- 13.1 standard deviation; majority Caucasian) with GH-deficiency (GHD) of different origin, derived from the prospective Pfizer International Metabolic Study (KIMS) Pharmacogenetics Study. Patients received GH-treatment for 12 months with finished dose-titration of GH and centralized IGF-1 measurements. GH-dose after 1 year of treatment, IGF-1 concentrations, IGF-1-standard deviation score (SDS), the IGF-1:GH ratio and anthropometric data were analyzed by genotype.
Except for rs1019731, which showed a significant difference of IGF-1-SDS by genotypes (p = 0.02), all polymorphisms showed no associations with the GH-doses, IGF-1 concentrations, IGF-1-SDS and IGF-1:GH ratio after adjusting for the confounding variables gender, age and BMI.
IGF-1 gene polymorphisms were not associated with the responsiveness to exogenous GH in GHD. Therefore, genetic variations of the IGF-1 gene seem not to be major influencing factors of the GH-IGF-axis causing variable response to exogenous GH-treatment.
据报道,胰岛素样生长因子-1(IGF-1)基因的多个单核苷酸多态性(SNP)以及一个微卫星胞嘧啶-腺嘌呤重复启动子多态性与循环IGF-1血清浓度相关。由于基因变异导致的IGF-1浓度差异可能会影响对生长激素(GH)治疗的不同反应,从而导致生长激素缺乏患者个体所需的GH剂量不同。本研究的目的是检验IGF-1基因多态性是否与生长激素缺乏的成年人的GH剂量相关。
在133名来自前瞻性辉瑞国际代谢研究(KIMS)药物遗传学研究的不同病因的德国成年生长激素缺乏(GHD)患者(66名男性,67名女性;平均年龄45.4岁±13.1标准差;大多数为白种人)中,确定了总共9个标签SNP、另外选择的5个SNP以及一个胞嘧啶-腺嘌呤重复多态性。患者接受GH治疗12个月,完成GH剂量滴定并进行集中的IGF-1测量。通过基因型分析治疗1年后的GH剂量、IGF-1浓度、IGF-1标准差评分(SDS)、IGF-1:GH比值和人体测量数据。
除rs1019731基因型间的IGF-1-SDS存在显著差异(p = 0.02)外,在调整了性别、年龄和BMI等混杂变量后,所有多态性与GH剂量、IGF-1浓度、IGF-1-SDS和IGF-1:GH比值均无关联。
IGF-1基因多态性与GHD患者对外源性GH的反应性无关。因此,IGF-1基因的遗传变异似乎不是导致对外源性GH治疗反应不同的GH-IGF轴的主要影响因素。