THE PREDISPOSITION FOR TYPE 2 DIABETES MELLITUS AND METABOLIC SYNDROME
Zenoaga-Barbăroșie C, Berca L, Vassu-Dimov T, Toma M, Nica MI, Alexiu-Toma OA, Ciornei C, Albu A, Nica S, Nistor C, Nica R
*Corresponding Author: Corresponding Author: Ass. Prof. Silvia Nica MD, PhD, Bucharest Emergency University Hospital, Splaiul Independentei Street, no 169, 5 District, Bucharest, Romania, 050098 Tel.: +40-21-31880500, email: silvia.nica@umfcd.ro
page: 21
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DISCUSSION
In this study, we evaluated the association between
six common polymorphisms in the ACE, eNOS, OXTR,
ATR1, CAT, and SOD1 genes with characteristics of T2DM
and MetS in Romanian Caucasian men. Thus, we tried to
avoid the impact of gender on these associations. Patients
with acute or chronic hyperglycemia have increased OS
levels can be predisposed to long term complications of
diabetes (21). SOD1 gene codes for an antioxidant enzyme
and therefore, it is a functional candidate for obesity (22),
T2DM, and its long-term complications (23). In our study,
SOD1 AA was a protective factor for T2DM (p<0.0006).
Concordant results were reported in the study by Flekac
et al., where both Czech males and females were included.
The authors reported that SOD1 +35A/C had potential effect
on enzyme activity and genotype AA was protective
for T2DM (p<0.05) (24). Additionally, in our study SOD1
AA and AC genotypes were associated with triglycerides
(p=0.0002 and p=0.0005, respectively) and HDL cho
lesterol (p=0.0002 and p=0.0004, respectively) levels in
T2DM patients. Our results are supported by previous
publications in which SOD1 concentration was negatively
correlated with HDL cholesterol concentration. However,
unlike previously published data, we found no statistically
significant association between SOD1 polymorphism and
obesity (p<0.05) (25).
Ethnicity and gender may explain, at last partially,
previous conflicting results regarding the impact of ACE
I/D in predisposition for T2DM (26). The ACE DD genotype
was found to increased risk of hypertension and/
or diabetes in Egyptian (27), Malaysian (28), Chinese
(29) populations, but not in Turkish (30) or Emirati (31).
Meta-analyses have also described a positive association
with subjects from Middle East, North Africa (26) or Asia
(32), whereas, among Europeans, the results are more
heterogenous (33,34). The number of ACE D variants
was correlated with an increase in ACE activity (35) and
angiotensin II signal transduction influences secretion of
oxytocin (36,37). Long-term ACE hyperactivity may predispose
to insulin hypersecretion and impairment of vessel
walls compliance which increase the risk for T2DM and
hypertension development (38). Although the distribution
of polymorphisms in ACE or OXTR did not differ between
our groups, the presence of both ACE I and OXTR A alleles
could be a protective factor for T2DM (OR=0.39,
p<0.0005).
OXTR mediates the impact of stressful experience
and influences social support seeking during distress (39).
OXTR polymorphisms may influence the response to stress,
via hypothalamic–pituitary–adrenal axis, and the risk for
stress-related disorders, including T2DM (13,39,40). Carriers
of the rs53576 G allele were more sensitive to both
favorable or negative surroundings and individuals with
GG genotype had altered cortisol levels and blood pressure
after rejection (39).
Predisposition to T2DM involves the interaction between
different genetic and non-genetic factors. It was
considered that moderate alcohol consumption (24 g/day)
is protective for T2DM development, while higher quantities
(60 g/day alcohol) represents a risk factor (41). In our
T2DM group, patients carrying the ACE DD genotype
were more often alcohol consumers. The association of
ACE DD with eNOS bb or with OXTR G were found more
frequently in drinking compared to non-drinking T2DM
patients. We found no association regarding the OXTR gene
polymorphisms and smoking habits in T2DM patients.
No association was identified concerning gene polymorphisms
in the MetS patients who reported being smokers
or drinking alcohol.
Our study indicated no significant association between
MetS and tested polymorphisms or between T2DM
and ATR1 A1166C or CAT-21A/T.
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