Diabetic Vascular Complications Laboratory, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Mohali, Mohali, Punjab, 140306, India.
Hum Genet. 2024 Jan;143(1):1-17. doi: 10.1007/s00439-023-02616-3. Epub 2023 Nov 24.
Diabetes mellitus (DM) has become a significant health concern with an increasing rate of morbidity and mortality worldwide. India ranks second in the number of diabetes cases in the world. The increasing burden of DM can be explained by genetic predisposition of Indians to type 2 diabetes mellitus (T2DM) coupled with rapid urbanization and socio-economic development in the last 3 decades leading to drastic changes in lifestyle. Environment and lifestyle changes contribute to T2DM development by altering epigenetic processes such as DNA methylation, histone post-translational modifications, and long non-coding RNAs, all of which regulate chromatin structure and gene expression. Although the genetic predisposition of Indians to T2DM is well established, how environmental and genetic factors interact and lead to T2DM is not well understood. In this review, we discuss the prevalence of diabetes and its complications across different states in India and how various risk factors contribute to its pathogenesis. The review also highlights the role of genetic predisposition among the Indian population and epigenetic factors involved in the etiology of diabetes. Lastly, we review current treatments and emphasize the knowledge gap with respect to genetic and epigenetic factors in the Indian context. Further understanding of the genetic and epigenetic determinants will help in risk prediction and prevention as well as therapeutic interventions, which will improve the clinical management of diabetes and associated macro- and micro-vascular complications.
糖尿病（DM）已成为一个严重的健康问题，在全球范围内发病率和死亡率不断上升。印度的糖尿病患者数量位居世界第二。在过去的 30 年里，印度人易患 2 型糖尿病（T2DM）的遗传倾向，加上快速的城市化和社会经济发展，导致生活方式发生了巨大变化，这可以解释糖尿病负担的增加。环境和生活方式的改变通过改变 DNA 甲基化、组蛋白翻译后修饰和长非编码 RNA 等表观遗传过程，从而导致 T2DM 的发生，所有这些过程都调节染色质结构和基因表达。尽管印度人易患 T2DM 的遗传倾向已得到充分证实，但环境和遗传因素如何相互作用并导致 T2DM 尚不清楚。在这篇综述中，我们讨论了印度不同邦的糖尿病患病率及其并发症，以及各种风险因素如何促成其发病机制。该综述还强调了印度人群中遗传易感性和参与糖尿病发病机制的表观遗传因素的作用。最后，我们回顾了目前的治疗方法，并强调了在印度背景下，遗传和表观遗传因素方面的知识差距。进一步了解遗传和表观遗传决定因素将有助于进行风险预测和预防以及治疗干预，从而改善糖尿病及其相关大血管和微血管并发症的临床管理。
