Törn Carina, Hadley David, Lee Hye-Seung, Hagopian William, Lernmark Åke, Simell Olli, Rewers Marian, Ziegler Anette, Schatz Desmond, Akolkar Beena, Onengut-Gumuscu Suna, Chen Wei-Min, Toppari Jorma, Mykkänen Juha, Ilonen Jorma, Rich Stephen S, She Jin-Xiong, Steck Andrea K, Krischer Jeffrey
Department of Clinical Sciences, Lund University/CRC, Malmö, Sweden
Pediatric Epidemiology Center, Department of Pediatrics, University of South Florida, Tampa, FL Division of Population Health Sciences and Education, St George's University of London, London, U.K.
Diabetes. 2015 May;64(5):1818-29. doi: 10.2337/db14-1497. Epub 2014 Nov 24.
The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively follows 8,677 children enrolled from birth who carry HLA-susceptibility genotypes for development of islet autoantibodies (IA) and type 1 diabetes (T1D). During the median follow-up time of 57 months, 350 children developed at least one persistent IA (GAD antibody, IA-2A, or micro insulin autoantibodies) and 84 of them progressed to T1D. We genotyped 5,164 Caucasian children for 41 non-HLA single nucleotide polymorphisms (SNPs) that achieved genome-wide significance for association with T1D in the genome-wide association scan meta-analysis conducted by the Type 1 Diabetes Genetics Consortium. In TEDDY participants carrying high-risk HLA genotypes, eight SNPs achieved significant association to development of IA using time-to-event analysis (P < 0.05), whereof four were significant after adjustment for multiple testing (P < 0.0012): rs2476601 in PTPN22 (hazard ratio [HR] 1.54 [95% CI 1.27-1.88]), rs2292239 in ERBB3 (HR 1.33 [95% CI 1.14-1.55]), rs3184504 in SH2B3 (HR 1.38 [95% CI 1.19-1.61]), and rs1004446 in INS (HR 0.77 [0.66-0.90]). These SNPs were also significantly associated with T1D in particular: rs2476601 (HR 2.42 [95% CI 1.70-3.44]). Although genes in the HLA region remain the most important genetic risk factors for T1D, other non-HLA genetic factors contribute to IA, a first step in the pathogenesis of T1D, and the progression of the disease.
青少年糖尿病环境决定因素(TEDDY)研究对8677名出生时携带HLA易感基因型的儿童进行了前瞻性跟踪,以观察胰岛自身抗体(IA)和1型糖尿病(T1D)的发生发展情况。在57个月的中位随访期内,350名儿童出现了至少一种持续性IA(谷氨酸脱羧酶抗体、IA-2抗体或微量胰岛素自身抗体),其中84人进展为T1D。我们对5164名白种儿童进行了41个非HLA单核苷酸多态性(SNP)的基因分型,这些SNP在1型糖尿病遗传联盟进行的全基因组关联扫描荟萃分析中与T1D的关联达到全基因组显著性水平。在携带高危HLA基因型的TEDDY参与者中,使用事件发生时间分析,8个SNP与IA的发生显著相关(P<0.05),其中4个在多重检验校正后仍具有显著性(P<0.0012):PTPN22基因中的rs2476601(风险比[HR]1.54[95%可信区间1.27-1.88])、ERBB3基因中的rs2292239(HR 1.33[95%可信区间1.14-1.55])、SH2B3基因中的rs3184504(HR 1.38[95%可信区间1.19-1.61])以及INS基因中的rs1004446(HR 0.77[0.66-0.90])。这些SNP与T1D也显著相关,尤其是rs2476601(HR 2.42[95%可信区间1.70-3.44])。虽然HLA区域的基因仍然是T1D最重要的遗传风险因素,但其他非HLA遗传因素也会影响IA(T1D发病机制的第一步)以及疾病的进展。