Morita Kazunori, Saruwatari Junji, Tanaka Takahiro, Oniki Kentaro, Kajiwara Ayami, Miyazaki Hiroko, Yoshida Akira, Jinnouchi Hideaki, Nakagawa Kazuko
Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Jinnouchi Clinic, Diabetes Care Center, Kumamoto, Japan.
J Diabetes Complications. 2017 Feb;31(2):483-488. doi: 10.1016/j.jdiacomp.2016.06.007. Epub 2016 Jun 14.
This study investigated the associations between the common hepatocyte nuclear factor-1A (HNF1A) variants and the risk of diabetic retinopathy (DR) in relation to the glycemic control and weight status.
A retrospective longitudinal analysis was conducted among 354 Japanese patients with type 2 diabetes mellitus (T2DM) (mean follow-up duration: 5.8±2.5 years). The multivariable-adjusted hazard ratio (HR) for the cumulative incidence of DR was calculated using a Cox proportional hazard model. During the observation period, the longitudinal associations of the HNF1A diplotypes with the risk of DR and the clinical parameters were also analyzed using the generalized estimating equations approach.
The combination of risk variants, i.e., rs1169288-C, rs1183910-A and rs2464196-A, was defined as the H1 haplotype. The incidence of DR was higher in the H1/H1 diplotype cases than in the others (HR 2.75 vs. non-H1/non-H1; p=0.02). Only in normal-weight subjects, the risks of DR and poor glycemic control were higher in the H1/H1 diplotype cases than in the others [odds ratio 4.08 vs. non-H1/non-H1, p=0.02; odds ratio 3.03, p=0.01; respectively].
This study demonstrated that the common HNF1A diplotype of three risk variants may be an independent risk factor for the development of DR resulting from poor glycemic control in normal-weight patients with T2DM. These results need to be replicated in larger and more varied study populations.
本研究调查了常见的肝细胞核因子-1A(HNF1A)变异与糖尿病视网膜病变(DR)风险之间的关联,以及与血糖控制和体重状况的关系。
对354例日本2型糖尿病(T2DM)患者进行了回顾性纵向分析(平均随访时间:5.8±2.5年)。使用Cox比例风险模型计算DR累积发病率的多变量调整风险比(HR)。在观察期内,还使用广义估计方程方法分析了HNF1A双倍型与DR风险和临床参数之间的纵向关联。
风险变异的组合,即rs1169288-C、rs1183910-A和rs2464196-A,被定义为H1单倍型。H1/H1双倍型病例的DR发病率高于其他病例(HR 2.75 vs.非H1/非H1;p = 0.02)。仅在正常体重受试者中,H1/H1双倍型病例的DR风险和血糖控制不佳的风险高于其他病例[优势比分别为4.08 vs.非H1/非H1,p = 0.02;优势比3.03,p = 0.01]。
本研究表明,三种风险变异的常见HNF1A双倍型可能是T2DM正常体重患者血糖控制不佳导致DR发生的独立危险因素。这些结果需要在更大且更多样化的研究人群中进行重复验证。