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      A Genome-Wide Association Study Identifies Susceptibility Variants for Type 2 Diabetes in Han Chinese

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          Abstract

          To investigate the underlying mechanisms of T2D pathogenesis, we looked for diabetes susceptibility genes that increase the risk of type 2 diabetes (T2D) in a Han Chinese population. A two-stage genome-wide association (GWA) study was conducted, in which 995 patients and 894 controls were genotyped using the Illumina HumanHap550-Duo BeadChip for the first genome scan stage. This was further replicated in 1,803 patients and 1,473 controls in stage 2. We found two loci not previously associated with diabetes susceptibility in and around the genes protein tyrosine phosphatase receptor type D ( PTPRD) ( P = 8.54×10 −10; odds ratio [OR] = 1.57; 95% confidence interval [CI] = 1.36–1.82), and serine racemase ( SRR) ( P = 3.06×10 −9; OR = 1.28; 95% CI = 1.18–1.39). We also confirmed that variants in KCNQ1 were associated with T2D risk, with the strongest signal at rs2237895 ( P = 9.65×10 −10; OR = 1.29, 95% CI = 1.19–1.40). By identifying two novel genetic susceptibility loci in a Han Chinese population and confirming the involvement of KCNQ1, which was previously reported to be associated with T2D in Japanese and European descent populations, our results may lead to a better understanding of differences in the molecular pathogenesis of T2D among various populations.

          Author Summary

          Type 2 diabetes (T2D) is a complex disease that involves many genes and environmental factors. Genome-wide and candidate-gene association studies have thus far identified at least 19 regions containing genes that may confer a risk for T2D. However, most of these studies were conducted with patients of European descent. We studied Chinese patients with T2D and identified two genes, PTPRD and SRR, that were not previously known to be involved in diabetes and are involved in biological pathways different from those implicated in T2D by previous association reports. PTPRD is a protein tyrosine phosphatase and may affect insulin signaling on its target cells. SRR encodes a serine racemase that synthesizes D-serine from L-serine. Both D-serine (coagonist) and the neurotransmitter glutamate bind to NMDA receptors and trigger excitatory neurotransmission in the brain. Glutamate signaling also regulates insulin and glucagon secretion in pancreatic islets. Thus, SRR and D-serine, in addition to regulating insulin and glucagon secretion, may play a role in the etiology of T2D. Our study suggests that, in different patient populations, different genes may confer risks for diabetes. Our findings may lead to a better understanding of the molecular pathogenesis of T2D.

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          Most cited references71

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          A genome-wide association study identifies novel risk loci for type 2 diabetes.

          Type 2 diabetes mellitus results from the interaction of environmental factors with a combination of genetic variants, most of which were hitherto unknown. A systematic search for these variants was recently made possible by the development of high-density arrays that permit the genotyping of hundreds of thousands of polymorphisms. We tested 392,935 single-nucleotide polymorphisms in a French case-control cohort. Markers with the most significant difference in genotype frequencies between cases of type 2 diabetes and controls were fast-tracked for testing in a second cohort. This identified four loci containing variants that confer type 2 diabetes risk, in addition to confirming the known association with the TCF7L2 gene. These loci include a non-synonymous polymorphism in the zinc transporter SLC30A8, which is expressed exclusively in insulin-producing beta-cells, and two linkage disequilibrium blocks that contain genes potentially involved in beta-cell development or function (IDE-KIF11-HHEX and EXT2-ALX4). These associations explain a substantial portion of disease risk and constitute proof of principle for the genome-wide approach to the elucidation of complex genetic traits.
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            The common PPARgamma Pro12Ala polymorphism is associated with decreased risk of type 2 diabetes.

            Genetic association studies are viewed as problematic and plagued by irreproducibility. Many associations have been reported for type 2 diabetes, but none have been confirmed in multiple samples and with comprehensive controls. We evaluated 16 published genetic associations to type 2 diabetes and related sub-phenotypes using a family-based design to control for population stratification, and replication samples to increase power. We were able to confirm only one association, that of the common Pro12Ala polymorphism in peroxisome proliferator-activated receptor-gamma(PPARgamma) with type 2 diabetes. By analysing over 3,000 individuals, we found a modest (1.25-fold) but significant (P=0.002) increase in diabetes risk associated with the more common proline allele (85% frequency). Moreover, our results resolve a controversy about common variation in PPARgamma. An initial study found a threefold effect, but four of five subsequent publications failed to confirm the association. All six studies are consistent with the odds ratio we describe. The data implicate inherited variation in PPARgamma in the pathogenesis of type 2 diabetes. Because the risk allele occurs at such high frequency, its modest effect translates into a large population attributable risk-influencing as much as 25% of type 2 diabetes in the general population.
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              Variants in MTNR1B influence fasting glucose levels.

              To identify previously unknown genetic loci associated with fasting glucose concentrations, we examined the leading association signals in ten genome-wide association scans involving a total of 36,610 individuals of European descent. Variants in the gene encoding melatonin receptor 1B (MTNR1B) were consistently associated with fasting glucose across all ten studies. The strongest signal was observed at rs10830963, where each G allele (frequency 0.30 in HapMap CEU) was associated with an increase of 0.07 (95% CI = 0.06-0.08) mmol/l in fasting glucose levels (P = 3.2 x 10(-50)) and reduced beta-cell function as measured by homeostasis model assessment (HOMA-B, P = 1.1 x 10(-15)). The same allele was associated with an increased risk of type 2 diabetes (odds ratio = 1.09 (1.05-1.12), per G allele P = 3.3 x 10(-7)) in a meta-analysis of 13 case-control studies totaling 18,236 cases and 64,453 controls. Our analyses also confirm previous associations of fasting glucose with variants at the G6PC2 (rs560887, P = 1.1 x 10(-57)) and GCK (rs4607517, P = 1.0 x 10(-25)) loci.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Genet
                plos
                plosgen
                PLoS Genetics
                Public Library of Science (San Francisco, USA )
                1553-7390
                1553-7404
                February 2010
                February 2010
                19 February 2010
                : 6
                : 2
                : e1000847
                Affiliations
                [1 ]School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
                [2 ]Department of Medical Genetics, Pediatrics and Medical Research, China Medical University Hospital, Taichung, Taiwan
                [3 ]Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
                [4 ]Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
                [5 ]National Genotyping Center, Academia Sinica, Taipei, Taiwan
                [6 ]Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
                [7 ]School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
                [8 ]Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
                [9 ]Department of Internal Medicine, Endocrinology and Metabolism, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
                [10 ]Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, United States of America
                [11 ]Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan
                Queensland Institute of Medical Research, Australia
                Author notes

                Conceived and designed the experiments: YT Chen, JY Wu. Performed the experiments: CF Yang, YM Liu, CC Chang. Analyzed the data: CF Shiu, P Chen, CH Chen, CSJ Fann. Contributed reagents/materials/analysis tools: FJ Tsai, CC Chen, LM Chuang, CH Lu, CT Chang, TY Wang, RH Chen. Wrote the paper: CF Yang, YT Chen, JY Wu.

                Article
                09-PLGE-RA-1070R5
                10.1371/journal.pgen.1000847
                2824763
                20174558
                18a059dd-dcf8-4d4e-8dd4-c726c2d6d2ae
                Tsai et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 25 June 2009
                : 18 January 2010
                Page count
                Pages: 9
                Categories
                Research Article
                Diabetes and Endocrinology
                Diabetes and Endocrinology/Type 2 Diabetes
                Genetics and Genomics
                Genetics and Genomics/Complex Traits
                Genetics and Genomics/Genetics of Disease
                Genetics and Genomics/Population Genetics

                Genetics
                Genetics

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