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December 1, 2008BMC Cardiovascular DisordersOpen Access

The Asp298 allele of endothelial nitric oxide synthase is a risk factor for myocardial infarction among patients with type 2 diabetes mellitus

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Key result

Homozygosity for the eNOS Asp298 allele synergistically increased the risk of acute myocardial infarction in patients with type 2 diabetes compared to wild-type non-diabetic subjects (HR 7.20).

Why the study?

Does the eNOS Asp298 allele increase the risk of acute myocardial infarction in patients with type 2 diabetes mellitus?

Population

1,202 subjects aged ≥40 years from Skara, Sweden, including 403 patients with type 2 diabetes mellitus and…

Comparison

Homozygosity for the endothelial nitric oxide… vs Wild-type homozygotes without diabetes and…

Design

Cohort

Follow-up

From baseline (1992-1994) through 2002

Authors

JOJacob OdebergScience for Life LaboratoryCLCharlotte LarssonLund UniversityLRLennart RåstamLund University

Discussion

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Overview

May aid MI risk stratification in type 2 diabetes; hypothesis-generating and needs prospective validation before clinical use.

Study Design

Type

Cohort (n=1,202)

Multicenter

No

Structured PICO

Does the eNOS Asp298 allele increase the risk of acute myocardial infarction in patients with type 2 diabetes mellitus?

P
Population
1,202 adults aged 40 and older, including 403 with type 2 diabetes and 799 healthy controls, followed for up to 10 years to assess the risk of acute myocardial infarction.
E
Exposure
Homozygosity for the endothelial nitric oxide synthase (eNOS) Asp298 allele (Asp298/Asp298 genotype).
C
Comparator
Wild-type homozygotes (Glu298/Glu298 genotype) without diabetes and hypertension.
O
Outcome
Fatal or non-fatal first events of acute myocardial infarction (AMI).hard clinical

Main Result

Hazard Ratio: 7.2 (95% CI 3.01–17.2)

p-value: p=<0.001

The eNOS Asp298 allele acts synergistically with type 2 diabetes mellitus to significantly increase the risk of acute myocardial infarction, particularly in women.

Limitations

  • Health status of the control population regarding diabetic status was not followed after baseline inclusion.
  • Stratification into T2DM, genotype, and sex resulted in small numbers within groups.
  • No information on the use of statins at baseline.
  • Definite data on menopause status was not available.
  • Did not follow the health status of the control population regarding diabetic status after baseline surveillance/inclusion
  • Stratification into T2DM, genotype, and sex resulted in small numbers within groups
  • No information on the use of statins at baseline
  • Definite data on menopause status was not available

Cite This Study

Odeberg et al. (2008) conducted a cohort in Type 2 diabetes mellitus and acute myocardial infarction (n=1,202). eNOS Asp298 allele homozygosity vs. Wild-type non-diabetic subjects was evaluated on Acute myocardial infarction (HR 7.20, 95% CI 3.01-17.20, p=<0.001). Homozygosity for the eNOS Asp298 allele synergistically increased the risk of acute myocardial infarction in patients with type 2 diabetes compared to wild-type non-diabetic subjects (HR 7.20).

synapsesocial.com/papers/6a95be36cef3090db24b5bf3https://doi.org/10.1186/1471-2261-8-36
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Endothelial Nitric Oxide Synthase Polymorphisms Are Associated With Type 2 Diabetes and the Insulin Resistance Syndrome2003 · 202 citations
  2. 2Therapeutic potential of nitric oxide donors in the prevention and treatment of atherosclerosis2005 · 148 citations
  3. 3Pyrosequencing Analysis of Thrombosis-Associated Risk Markers2005 · 25 citations
  4. 4Diabetes and Vascular Disease2003 · 1,659 citations
  5. 5The Skaraborg Hypertension Project1986 · 16 citations