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遗传信息与高危多民族人群 2 型糖尿病发病预测:EpiDREAM 遗传学研究。

Genetic information and the prediction of incident type 2 diabetes in a high-risk multiethnic population: the EpiDREAM genetic study.

机构信息

Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton General Hospital, Hamilton, Ontario, Canada.

出版信息

Diabetes Care. 2013 Sep;36(9):2836-42. doi: 10.2337/dc12-2553. Epub 2013 Apr 19.

Abstract

OBJECTIVE

To determine if 16 single nucleotide polymorphisms (SNPs) associated with type 2 diabetes (T2DM) in Europeans are also associated with T2DM in South Asians and Latinos and if they can add to the prediction of incident T2DM in a high-risk population.

RESEARCH DESIGN AND METHODS

In the EpiDREAM prospective cohort study, physical measures, questionnaires, and blood samples were collected from 25,063 individuals at risk for dysglycemia. Sixteen SNPs that have been robustly associated with T2DM in Europeans were genotyped. Among 15,466 European, South Asian, and Latino subjects, we examined the association of these 16 SNPs alone and combined in a gene score with incident cases of T2DM (n = 1,016) that developed during 3.3 years of follow-up.

RESULTS

Nine of the 16 SNPs were significantly associated with T2DM, and their direction of effect was consistent across the three ethnic groups. The gene score was significantly higher among subjects who developed incident T2DM (cases vs. noncases: 16.47 [2.50] vs. 15.99 [2.56]; P = 0.00001). The gene score remained an independent predictor of incident T2DM, with an odds ratio of 1.08 (95% CI 1.05-1.11) per additional risk allele after adjustment for T2DM risk factors. The gene score in those with no family history of T2DM was 16.02, whereas it was 16.19 in those with one parent with T2DM and it was 16.32 in those with two parents with T2DM (P trend = 0.0004). The C statistic of T2DM risk factors was 0.708 (0.691-0.725) and increased only marginally to 0.714 (0.698-0.731) with the addition of the gene score (P for C statistic change = 0.0052).

CONCLUSIONS

T2DM genetic associations are generally consistent across ethnic groups, and a gene score only adds marginal information to clinical factors for T2DM prediction.

摘要

目的

确定在欧洲人群中与 2 型糖尿病(T2DM)相关的 16 个单核苷酸多态性(SNP)是否也与南亚人和拉丁裔人群中的 T2DM 相关,以及它们是否可以增加高危人群中 T2DM 的预测。

研究设计和方法

在 EpiDREAM 前瞻性队列研究中,从易发生糖代谢异常的 25063 名个体中收集了体格测量、问卷调查和血样。对欧洲人群中与 T2DM 显著相关的 16 个 SNP 进行了基因分型。在 15466 名欧洲人、南亚人和拉丁裔个体中,我们研究了这些 16 个 SNP 单独和组合成基因评分与 3.3 年随访期间发生的 1016 例 T2DM 新发病例(病例)的相关性。

结果

在三个种族群体中,有 9 个 SNP 与 T2DM 显著相关,其作用方向一致。发生 T2DM 的个体的基因评分显著较高(病例与非病例:16.47[2.50]与 15.99[2.56];P=0.00001)。基因评分仍然是 T2DM 的独立预测因子,在校正 T2DM 危险因素后,每增加一个风险等位基因,其比值比为 1.08(95%CI 1.05-1.11)。无 T2DM 家族史的个体的基因评分 16.02,有 1 位父母患有 T2DM 的个体的基因评分 16.19,有 2 位父母患有 T2DM 的个体的基因评分 16.32(P 趋势=0.0004)。T2DM 危险因素的 C 统计量为 0.708(0.691-0.725),加入基因评分后仅略有增加至 0.714(0.698-0.731)(P 为 C 统计量变化=0.0052)。

结论

T2DM 遗传关联在不同种族群体中基本一致,基因评分仅为 T2DM 预测提供了临床因素的微小信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/887f/3747911/a0c1636d18d3/2836fig1.jpg

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