Insulin-gene sharing in sib pairs with insulin-dependent diabetes mellitus: no evidence for linkage.

An association between insulin-dependent diabetes mellitus (IDDM) and an RFLP adjacent to the insulin gene has been consistently observed, but its etiological significance is unclear. We studied unrelated IDDM patients (N = 45) and controls (N = 65) to confirm the association--and assessed evidence for linkage in 22 families with at least two affected (IDDM) sibs--to determine whether the insulin-gene region actually contributes to susceptibility to IDDM. All individuals were typed for the RFLP in the 5'-flanking region of the insulin gene (5'FP) used in the previous studies, and the 12 families not fully informative for linkage with the 5'FP were typed for additional closely linked RFLPs. We found a higher frequency of class 1 alleles of the 5'FP in IDDM patients (.83) than in controls (.75), which is consistent with the reported association, but the difference was not statistically significant in our sample. Among the 33 affected sib pairs (ASPs) in 22 families, if maximum possible sharing is assumed when sharing is ambiguous, 10 pairs share both parental insulin genes, 17 pairs share one, and six share neither. This distribution is incompatible with close linkage. In contrast, for the HLA region, for which all 22 families are fully informative, 19 of the 33 ASPs share two haplotypes and the remaining 14 share one. There are no pairs that share neither HLA haplotype. Thus, although these data clearly illustrate the contribution of HLA-linked susceptibility to IDDM, they argue strongly against a contribution of similar magnitude by the insulin-gene region.