Povezanost polimorfizama gena za adiponektin i rezistin sa rizikom za poremećaj nutritivnog statusa pacijenata sa dijabetesom tipa 2/

Abstract

Uvod: Pothranjenosti je čest komorbiditet (do 25%) kod pacijenata sa dijabetesom tipa 2 (T2D), koji značajno narušava njihovo zdravlje. Glavni cilj naše studije bio je da procijeni povezanost polimorfizama pojedinačnih nukleotida (eng. Single nucleotide polymorphism, SNP) gena adiponektina (ADIPOQ) +276 (G/T) i rezistina (RETN) -420 (C/G) sa rizikom od razvoja T2D i rizikom od poremećaja nutritivnog statusa kod pacijenata sa T2D. Metode: Istraživanje je sprovedeno među 106 pacijenata sa T2D i 106 zdravih kontrolnih ispitanika, kao studija slučаjeva-kontrola na teritoriji Republike Srpske, Bosna i Hercegovina u periodu od 1. septembra do 31. decembra 2022. godine. Dijagnoza T2D postavljena je od strane endokrinologa (WHO, 2005.) i prema kriterijumima američkog dijabetološkog udruženja (engl. American Diabetes Association, ADA), gdje je vrijednost glukoze u krvi natašte (eng. Fasting blood glucose, FBG) u trenutku dijagnoze bila viša od 7,0 mmol/L (127 mg/dL) i HbA1c bio veći od 6,5% (48 mmol/L). Dijagnoza je kasnije potvrđena oralnim testom tolerancije na glukozu (OGTT). Za procjenu nutritivnog statusa korišćen je mini nutritivni test (engl. Mini Nutritional Assessment, MNA). Analiza DNK je izvedena pomoću lančane reakcije polimeraze (engl. Polymerase Chain Reaction, PCR) sa restrikcionom analizom proizvoda. Rezultati: U istraživanje je bilo uključeno 212 ispitanika, od kojih su 124 (58,5%) bili muškarci. Prosječna starost ispitanika iznosila je 68,48 ± 4,67 godina. Skoro 20% (n=42) ispitanika bilo je pothranjeno, pri čemu su pacijenti sa T2D značajno češće bili pothranjni u poređenju sa kontrolama (33% naspram 6,6%; p < 0,001). Genotip ADIPOQ +276 GT, kao i kombinovani genotipovi (GT + TT), identifikovani su kao značajni prediktori za T2D (p = 0,007 naspram p = 0,005) i poremećaj pothranjenosti (p = 0,001 naspram p = 0,023) u populaciji sa T2D. S druge strane, prisustvo individualnog RETN -420 CG i kombinovanih CG + TT genotipova imalo je zaštitni efekat protiv pojave T2D (p = 0,023 naspram p = 0,036). Zaključak: RETN genotipovi nisu bili povezani sa poremećajem pothranjenosti. Polimorfizmi gena ADIPOQ +276 predstavljaju značajan prediktor za razvoj T2D i poremećaja pothranjenosti u populaciji sa T2D, dok je polimorfizam gena RETN -420 identifikovan kao značajan faktor povezan sa smanjenim rizikom od T2D, ali nije bio povezan sa pothranjenošću.

Introduction: Undernutrition disorder is a prevalent comorbidity (up to 25%) in type 2 diabetes (T2D) patients which significantly compromises their health. The main goal of our study was to assess the association between single nucleotide polymorphysms (SNPs) adiponectin (ADIPOQ) +276 (G/T) and resistin (RETN) -420 (C/G) gene polymorphisms with the risk of developing T2D and risk for nutrition disorders in patients with T2D. Methods: The research was conducted among 106 patients with T2D and 106 healthy control individuals, as case-control study in the territory of the Republic of Srpska, Bosnia and Herzegovina from September 1 to December 31, 2022. The diagnosis of T2D was made by an endocrinologist (WHO, 2005) and according to the criteria of The American Diabetes Association (ADA), where the Fasting blood glucose test (FBG) value at the time of diagnosis was higher than 7,0 mmol/L (127 mg/dL) and HbA1c was higher than 6,5% (48 mmol/L). For assessing the nutritional status the mini nutritional assessment (MNA) was used. DNA analysis was carried out by polymerase chain reaction with restriction analysis of PCR product. Results: The research included 212 subjects of which 124 (58.5%) were male. The mean age of the subjects was 68.48±4,67 years. Almost 20% (n=42) of subjects were undernourished, significantly more T2D patients when compared to controls (33% vs. 6.6%; p < 0.001). ADIPOQ +276 GT individual GT and combined genotypes (GT + TT) were identified as significant predictors of T2D (p = 0.007 vs. p = 0.005) and undernutrition disorder (p = 0.001 vs. p = 0.023) in T2D population, while the presence of individual RETN -420 CG and combined CG + TT genotypes had protective effect against occurrence of T2D (p = 0.023 vs. p = 0.036). Conclusion: RETN genotypes were not associated with undernutrition disorder. ADIPOQ +276 gene polymorphisms represent a significant predictor for development of T2D and undernutrition disorder in T2D population, while RETN -420 gene polymorphism was identified as a significant factor associated with a reduced risk for T2D, but was not associated with undernutrition.