Department of Surgery, Dentistry, Gynecology and Pediatrics, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera, Università di Verona, Piazzale A. Stefani, 1, 37126, Verona, Italy.
Acta Diabetol. 2023 Oct;60(10):1351-1358. doi: 10.1007/s00592-023-02128-6. Epub 2023 Jun 20.
Several genetic loci have been associated with diabetic nephropathy; however, the underlying genetic mechanisms are still poorly understood, with no robust candidate genes identified yet.
We aimed to determine whether two polymorphisms, previously associated with renal decline, influence kidney impairment evaluating their association with markers of renal function in a pediatric population with type 1 diabetes (T1D).
Renal function was evaluated by glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) in a cohort of pediatric subjects with T1D (n = 278). Risk factors for diabetes complications (diabetes duration, blood pressure, HbA1c) were assessed. The IGF1 rs35767 and PPARG rs1801282 SNPs were genotyped by TaqMan RT-PCR system. An additive genetic interaction was calculated. Association analysis between markers of renal function and both SNPs or their additive interaction were performed.
Both SNPs showed a significant association with eGFR: the A allele of rs35767 or the C allele of rs1801282 were associated to reduced eGFR compared to G alleles. Multivariate regression analysis adjusted for age, sex, z-BMI, T1D duration, blood pressure and Hba1c values showed that the additive genetic interaction was independently associated with lower eGFR (β = -3.59 [-6.52 to -0.66], p = 0.017). No associations were detected between SNPs, their additive interaction and ACR.
These results provide new insight into the genetic predisposition to renal dysfunction, showing that two polymorphisms in IGF1 and PPARG genes can lead to a reduction in renal filtration rate leading these patients to be exposed to a higher risk of early renal complications.
已有多个遗传位点与糖尿病肾病相关;然而,潜在的遗传机制仍知之甚少,尚未确定稳健的候选基因。
我们旨在确定先前与肾功能下降相关的两个多态性是否会影响肾功能损害,并在 1 型糖尿病 (T1D) 患儿人群中评估它们与肾功能标志物的相关性。
在 278 名 T1D 患儿队列中,通过肾小球滤过率 (eGFR) 和白蛋白与肌酐比值 (ACR) 评估肾功能。评估了糖尿病并发症的危险因素 (糖尿病病程、血压、HbA1c)。通过 TaqMan RT-PCR 系统对 IGF1 rs35767 和 PPARG rs1801282 SNP 进行基因分型。计算了 IGF1 rs35767 和 PPARG rs1801282 之间的加性遗传相互作用。对肾功能标志物与两个 SNP 或其加性相互作用的相关性进行了分析。
两个 SNP 均与 eGFR 有显著相关性:与 G 等位基因相比,rs35767 的 A 等位基因或 rs1801282 的 C 等位基因与 eGFR 降低相关。调整年龄、性别、z-BMI、T1D 病程、血压和 Hba1c 值的多变量回归分析显示,加性遗传相互作用与较低的 eGFR 独立相关 (β = -3.59 [-6.52 至 -0.66],p = 0.017)。未检测到 SNP、其加性相互作用与 ACR 之间存在相关性。
这些结果为肾功能障碍的遗传易感性提供了新的见解,表明 IGF1 和 PPARG 基因中的两个多态性可导致肾小球滤过率降低,使这些患者面临更高的早期肾脏并发症风险。