低血糖制御と9p21ロカスとの相互作用は,2型糖尿病における冠動脈疾患のリスクに影響する
Alessandro Doria1, Joanna Wojcik, Rui Xu
1Research Division, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA. alessandro.doria@joslin.harvard.edu
JAMA
|November 27, 2008
まとめ
9p21の遺伝子変異は,2型糖尿病患者の冠動脈疾患 (CAD) のリスクを高め,特に低血糖コントロールと併用すると特に危険です. この相互作用は,CADと死亡率の両方のリスクを大幅に拡大します.
科学分野:
- 遺伝学 遺伝学とは
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
背景:
- 一般的な9p21染色体アレルは,一般の人々の冠動脈疾患 (CAD) リスクと関連しています.
- この9p21変異が2型糖尿病患者集団におけるCADリスクに与える影響は不明である.
研究 の 目的:
- 2型糖尿病患者における9p21遺伝子変異とCADの関連性を調査する.
- 9p21変異体と低血糖制御によるCADリスクと死亡率との相互作用を評価する.
主な方法:
- 症例対照研究では,734人の2型糖尿病患者 (322人がCAD,412人が無) が参加しました.
- 独立したコホート研究では,475人の2型糖尿病患者の10年死亡率をモニタリングした.
- 参加者は9p21単核酸多様性 (rs2383206) に関してゲノタイプ化され,長期の血糖コントロール (HbA1c) について評価されました.
主要な成果:
- 9p21リスクアレルに同位体を持つ個人は,著しく高いCAD率 (42.3%対28.9%) を示した.
- 9p21変異と関連したCADリスクは,低血糖制御によって大幅に増幅された (相互作用P = .048).
- 低血糖制御と9p21リスク遺伝子型との組み合わせにより,CADの確率が4倍になり,10年後の死亡リスクが増加しました.
結論:
- 9p21の遺伝子変異は,2型糖尿病患者の冠動脈疾患のリスクを高めます.
- この増加したリスクは,低血糖コントロールの存在によって著しく悪化します.
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