
MATRIX METALLOPROTEINASE-2 (MMP-2 )
AND-9 (MMP-9) GENE VARIANTS AND MICROVASCULAR
COMPLICATIONS IN TYPE 2 DIABETES PATIENTS Andjelic Jelic M٭ˡ, Radojkovic D², Nikolic A², Rakicevic Lj², Babic T², Jelic D³, Lalic NM⁴ *Corresponding Author: Marina Andjelic Jelic, Department of Endocrinology, Diabetes and Metabolic
Diseases, Clinical Medical Centre Zvezdara, Dimitrija Tucovica 161, 11000 Belgrade, Serbia, Phone +381 64 122 2010 Fax +381 11 3088733, E mail: drmajelic@gmail.com page: 6
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DISCUSSION
In our study, our primary goal was to assess the possible
differences in MMP-2 and MMP-9 gene polymorphism
between patients with type 2 diabetes and healthy controls.
Our results showed that the presence of the MMP-2 allele
-1306C nearly doubles the risk of developing type 2 diabetes
mellitus, while the -1306T allele provides protection
against this disease. This correlates with the results of Sarray
et al., who, for the first time, showed an association of
the MMP-2-1306C>T gene variant with the susceptibility
to developing type 2 diabetes, therefore confirming the
protective effect of the T allele. [35]
To our knowledge, this is the first study investigating
MMP-2 and MMP-9 genetic variants and all three microvascular
complications.
Regarding DR and a possible genetic background,
Singh K. et al. postulated that the functional SNP -1562C>T
in the promoter of the MMP-9 gene plays a very important
role in developing proliferative DR due to the elevated
MMP-9 production from the high expressing T allele leading
to retinal angiogenesis [20].
A statistically significant difference was observed in
both allele and genotype distributions, but only between
patients with proliferative retinopathy versus healthy controls
with no DM. There were, however, no significant
differences between patients with DM, no matter if they
have DR or not. This is the same result as our study. Due
to the limited number of patients with proliferative retinopathy
we were not able to establish if there is a significant
difference between these patients and healthy controls.
In another study, Beranek M. et al. showed that plasma
levels of MMP-2 were significantly higher in patients
with proliferative DR who were carriers of the -1306 CC
or the -1306 CT genotypes [21]. In Beranek’s study, no
major differences were found among the groups (diabetics
with non-proliferative DR, diabetics with proliferative
DR, and healthy controls) when comparing the genotype
distribution for MMP-2-1306C>T and MMP-9-1562 C>T
variants. This is consistent with our results.
MMPs are regarded as very important players in the
development of diabetic polyneuropathy, not only by caus-ing extracellular matrix abnormalities but also by causing
neuronal injury which leads to the development of neuropathic
pain. So far, no genetic study has been performed
regarding MMP gene variants and the presence of DPN.
Our results showed that the presence of the MMP-2 allele
-1306C increases the probability of developing diabetic
polyneuropathy by a factor of 3.4 times. This can be potentially
used as genetic marker for detecting those diabetic
patients who are at risk of developing this threatening
vascular complication. Of course, we need more extensive
studies to confirm this finding.
We found no correlation between either MMP-2 or
MMP-9 gene variants and diabetic nephropathy. This was
probably due to the limited number of patients with this
complication in the study group.
In conclusion, our study showed that the variant
-1306C>T in the MMP-2 gene doubles the risk of developing
type 2 diabetes, and we showed, for the first time,
an association of this gene variant and the presence of
diabetic polyneuropathy. As matrix metalloproteinases
play an important role in the development of vascular
diabetic complications, future studies with a larger number
of patients are needed so as to verify variants in the genes
for MMPs as markers for diabetic complications .
Declaration of Interest. The authors report no conflict
of interest. The authors alone are responsible for the
content and writing of this article.
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