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KCNQ1基因多态性与中国2型糖尿病患者对磺脲类药物的治疗反应相关。

Polymorphisms of the KCNQ1 gene are associated with the therapeutic responses of sulfonylureas in Chinese patients with type 2 diabetes.

作者信息

Li Qing, Tang Ting-Ting, Jiang Feng, Zhang Rong, Chen Miao, Yin Jun, Bao Yu-Qian, Cheng Xiang, Hu Cheng, Jia Wei-Ping

机构信息

Department of Endocrinology & Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory for Diabetes Mellitus, Shanghai 200233, China.

Laboratory of Cardiovascular Immunology, Institute of Cardiology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China.

出版信息

Acta Pharmacol Sin. 2017 Jan;38(1):80-89. doi: 10.1038/aps.2016.103. Epub 2016 Oct 3.

Abstract

KCNQ1 channel is a member of the voltage-gated potassium channel KQT-like subfamily. The KCNQ1 gene has recently been identified as a susceptibility locus for type 2 diabetes mellitus (T2DM). In the present study, we examined the effects of KCNQ1 variants on the therapeutic response to modified-release gliclazide (gliclazide MR) treatment in Chinese patients newly diagnosed with T2DM. A total of 100 newly diagnosed T2DM patients without a history of any anti-diabetic medications were treated with gliclazide MR for 16 weeks, but 91 patients completed the entire study. The anthropometric parameters were determined at baseline and at the final visit, while clinical laboratory tests were performed at baseline and on weeks 2, 4, 6, 12, 16. Two SNPs, rs2237892 and rs2237895, in the region of the KCNQ1 gene were genotyped in all the participants. All calculations and statistical analyses were conducted using SPSS. The rs2237892 TT homozygotes exhibited significantly higher 2-h glucose levels at baseline (P<0.05) and a lower cumulative attainment rate of the target 2-h glucose level (P=0.020) than the C allele carriers. Patients with greater numbers of rs2237892 T alleles exhibited larger augmentations (Δ) in the 2-h glucose levels (P=0.027); and patients with the rs2237892 TT genotype exhibited a higher Δ homeostasis model assessment of β-cell function (HOMA-β) than CC and CT genotype carriers (P=0.021 and P=0.043, respectively). Moreover, the rs2237895 C allele was associated with a greater decrement in Δ glycated hemoglobin (HbA1c) (P=0.024); and patients with the CC genotype exhibited greater variance than those with the AA and AC genotypes (P=0.005 and 0.021, respectively). Compared with the C allele, the odds ratio for treatment success among carriers of the rs2237892 T allele was 2.533 (P=0.007); and the rs2237895 C allele was associated with a 2.360-fold decrease in HbA1c compared with the A allele (P=0.009). KCNQ1 polymorphisms are associated with gliclazide MR efficacy in Chinese patients with type 2 diabetes.

摘要

KCNQ1通道是电压门控钾通道KQT样亚家族的成员。KCNQ1基因最近被确定为2型糖尿病(T2DM)的一个易感基因座。在本研究中,我们检测了KCNQ1基因变异对新诊断的中国T2DM患者接受缓释格列齐特(格列齐特缓释片)治疗的疗效的影响。共有100例无任何抗糖尿病药物治疗史的新诊断T2DM患者接受格列齐特缓释片治疗16周,但91例患者完成了整个研究。在基线和末次访视时测定人体测量参数,并在基线以及第2、4、6、12、16周进行临床实验室检查。对所有参与者的KCNQ1基因区域内的两个单核苷酸多态性(SNP),即rs2237892和rs2237895进行基因分型。所有计算和统计分析均使用SPSS进行。与C等位基因携带者相比,rs2237892 TT纯合子在基线时2小时血糖水平显著更高(P<0.05),且目标2小时血糖水平的累积达标率更低(P=0.020)。rs2237892 T等位基因数量较多的患者2小时血糖水平的升高幅度(Δ)更大(P=0.027);rs2237892 TT基因型患者的β细胞功能稳态模型评估(HOMA-β)升高幅度高于CC和CT基因型携带者(分别为P=0.021和P=0.043)。此外,rs2237895 C等位基因与糖化血红蛋白(HbA1c)下降幅度更大相关(P=0.024);CC基因型患者的变异性高于AA和AC基因型患者(分别为P=0.005和0.021)。与C等位基因相比,rs2237892 T等位基因携带者治疗成功的比值比为2.533(P=0.007);与A等位基因相比,rs2237895 C等位基因与HbA1c降低2.360倍相关(P=0.009)。KCNQ1基因多态性与中国2型糖尿病患者格列齐特缓释片的疗效相关。

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