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中国汉族人群中2型糖尿病遗传风险评分与受胰岛素敏感性调节的胰岛素分泌的关联。

Association of a type 2 diabetes genetic risk score with insulin secretion modulated by insulin sensitivity among Chinese Hans.

作者信息

Kong X, Xing X, Hong J, Zhang X, Yang W

机构信息

Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.

出版信息

Clin Genet. 2017 Jun;91(6):832-842. doi: 10.1111/cge.12817. Epub 2016 Jul 21.

Abstract

Type 2 diabetes (T2D) is characterized by insulin resistance and impaired insulin secretion. The present study aimed to identify the influence of insulin sensitivity on the genetic risk of impaired insulin secretion among a Chinese Han population. For 3229 controls and 1994 treatment-naïve T2D, single nucleotide polymorphisms (SNPs) from 24 T2D-related genomic loci were genotyped and a genetic risk score (GRS) was constructed. Results showed that GRS was associated with insulin secretion and disposition indices in both controls and treatment-naïve T2Ds. Upon stratifying the participants into tertiles by the Matsuda index, we observed an inhibitory relationship between the GRS and insulin secretion in low insulin sensitive but not in high insulin sensitive controls and treatment-naïve T2Ds. Moreover, low insulin sensitive individuals exhibited more severe impairment in insulin secretion and beta cell response to insulin sensitivity with an increase in risk alleles. Our findings identified that the association of GRS with insulin secretion was strongly modulated by insulin sensitivity in both controls and T2Ds of Chinese Han. It indicates that insulin sensitization should be emphasized in prevention and treatment of T2D for beta cell protection.

摘要

2型糖尿病(T2D)的特征是胰岛素抵抗和胰岛素分泌受损。本研究旨在确定中国汉族人群中胰岛素敏感性对胰岛素分泌受损遗传风险的影响。对3229名对照者和1994名未经治疗的T2D患者进行了基因分型,检测了24个与T2D相关基因组位点的单核苷酸多态性(SNP),并构建了遗传风险评分(GRS)。结果显示,GRS与对照者和未经治疗的T2D患者的胰岛素分泌及处置指数均相关。根据松田指数将参与者分为三分位数后,我们观察到在低胰岛素敏感性的对照者和未经治疗的T2D患者中,GRS与胰岛素分泌之间存在抑制关系,而在高胰岛素敏感性的对照者和未经治疗的T2D患者中则不存在这种关系。此外,低胰岛素敏感性个体随着风险等位基因的增加,胰岛素分泌和β细胞对胰岛素敏感性的反应受损更为严重。我们的研究结果表明,在中国汉族对照者和T2D患者中,GRS与胰岛素分泌之间的关联受到胰岛素敏感性的强烈调节。这表明在T2D的预防和治疗中,应强调胰岛素增敏以保护β细胞。

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