Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.
Service of Infectious Diseases, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Am J Transplant. 2019 Jan;19(1):238-246. doi: 10.1111/ajt.14971. Epub 2018 Jul 13.
New-onset diabetes mellitus after transplantation (NODAT) is a complication following solid organ transplantation (SOT) and may be related to immune or inflammatory responses. We investigated whether single nucleotide polymorphisms (SNPs) within 158 immune- or inflammation-related genes contribute to NODAT in SOT recipients. The association between 263 SNPs and NODAT was investigated in a discovery sample of SOT recipients from the Swiss Transplant Cohort Study (STCS, n = 696). Positive results were tested in a first STCS replication sample (n = 489) and SNPs remaining significant after multiple test corrections were tested in a second SOT replication sample (n = 156). Associations with diabetic traits were further tested in several large general population-based samples (n > 480 000). Only SP110 rs2114592C>T remained associated with NODAT in the STCS replication sample. Carriers of rs2114592-TT had 9.9 times (95% confidence interval [CI]: 3.22-30.5, P = .00006) higher risk for NODAT in the combined STCS samples (n = 1184). rs2114592C>T was further associated with NODAT in the second SOT sample (odds ratio: 4.8, 95% CI: 1.55-14.6, P = .006). On the other hand, SP110 rs2114592C>T was not associated with diabetic traits in population-based samples, suggesting a specific gene-environment interaction, possibly due to the use of specific medications (ie, immunosuppressants) in transplant patients and/or to the illness that may unmask the gene effect.
移植后新发糖尿病(NODAT)是实体器官移植(SOT)后的一种并发症,可能与免疫或炎症反应有关。我们研究了 158 个免疫或炎症相关基因中的单核苷酸多态性(SNP)是否与 SOT 受者的 NODAT 有关。在瑞士移植队列研究(STCS)的 SOT 受者发现样本中(n = 696),对 263 个 SNP 与 NODAT 的相关性进行了研究。阳性结果在 STCS 的第一个复制样本中进行了测试(n = 489),并在第二个 SOT 复制样本中测试了经过多次测试校正后仍然显著的 SNP(n = 156)。在几个大型基于一般人群的样本(n > 480 000)中进一步测试了与糖尿病特征的关联。在 STCS 复制样本中,只有 SP110 rs2114592C>T 与 NODAT 仍然相关。rs2114592-TT 携带者在合并的 STCS 样本(n = 1184)中发生 NODAT 的风险增加了 9.9 倍(95%置信区间 [CI]:3.22-30.5,P =.00006)。rs2114592C>T 与第二个 SOT 样本中的 NODAT 进一步相关(优势比:4.8,95% CI:1.55-14.6,P =.006)。另一方面,SP110 rs2114592C>T 与基于人群的样本中的糖尿病特征无关,表明存在特定的基因-环境相互作用,可能是由于移植患者使用了特定的药物(即免疫抑制剂)和/或疾病可能揭示了基因的作用。