Key result
The PPARγ C161T polymorphism was significantly associated with a reduced risk of severe vessel stenosis in Chinese patients with coronary artery disease and type 2 diabetes (OR 1.22 for the CC risk genotype).
Why the study?
Does the PPARγ C161→T polymorphism alter the risk and severity of coronary artery disease in Chinese patients with type 2 diabetes mellitus?
Observational (n=556)
Yes
Does the PPARγ C161→T polymorphism alter the risk and severity of coronary artery disease in Chinese patients with type 2 diabetes mellitus?
Odds Ratio: 1.22 (95% CI 1.03–1.45)
Absolute Event Rate: 42.2% vs 56.2%
p-value: p=0.019
The PPARγ C161→T polymorphism is associated with reduced severity of coronary atherosclerosis and improved lipid profiles (lower triglycerides and apoB) in Chinese patients with concurrent CAD and T2DM.
Hypothesis-generating for genetic stratification in Chinese T2DM-CAD; requires prospective validation before any clinical use.
BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPARgamma) is a ligand-activated transcription factor, which regulates gene expression of the key proteins involved in lipid metabolism, vascular inflammation, and proliferation. PPARgamma may contribute to attenuating atherogenesis and postangioplasty restenosis. PPARgamma C161-->T substitution is associated with a reduced risk of coronary artery disease (CAD). Whether or not the gene substitution alters the risk of CAD in type 2 diabetes mellitus (T2DM) patients remains unclear. METHODS: A total of 556 unrelated subjects from a Chinese Han population, including 89 healthy subjects, 78 CAD patients, 86 T2DM patients, and 303 CAD combined with T2DM patients, were recruited to enroll in this study. PPARgammaC161-->T gene polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphisms. Plasma levels of lipoproteins, apolipoproteins, glucose, and insulin were measured by ELISA or radioimmunoassay (RIA). The coronary artery lesions were evaluated by coronary angiography. RESULTS: The frequency of the 161T allele in CAD, T2DM, and CAD combined with T2DM patients was similar to that observed in the healthy control group. However, in CAD combined with T2DM patients, the group with angiographically documented moderate stenoses had a higher frequency of the 161T allele in comparison to the group with severe stenoses (P < 0.05). Moreover, in CAD with T2DM patients, the triglyceride levels and apoB in CC homozygote carriers were significantly higher than those in "T" allele carriers. CONCLUSIONS: PPARgammaC161-->T genotypes weren't significantly associated with the risk of CAD, but were markedly correlated with severity of disease vessels in patients with CAD and T2DM. Furthermore, PPARgammaC161-->T substitution was associated with an altered adipose, but not glucose metabolism. These results indicate that the PPARgamma C161-->T polymorphism may reduce the risk of severe atherogenesis by modulation of adipose metabolism, especially triglycerides and apoB, in Chinese patients with CAD and T2DM.
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Wan et al. (2010) conducted an observational in Coronary artery disease and type 2 diabetes mellitus (n=556). PPARγ C161T polymorphism vs. CC genotype was evaluated on Severe vessel stenosis (>75%) in patients with CAD and T2DM (OR 1.22, 95% CI 1.03-1.45, p=0.019). The PPARγ C161T polymorphism was significantly associated with a reduced risk of severe vessel stenosis in Chinese patients with coronary artery disease and type 2 diabetes (OR 1.22 for the CC risk genotype).
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