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Increased genetic risk for β-cell failure is associated with β-cell function decline in people with prediabetes

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posted on 2024-05-17, 14:49 authored by Liana K. Billings, Kathleen A. Jablonski, Qing Pan, Paul W. Franks, Ronald B. Goldberg, Marie-France Hivert, Steven E. Kahn, William C. Knowler, Christine G. Lee, Jordi Merino, Alicia Huerta-Chagoya, Josep M. Mercader, Sridharan Raghavan, Zhuqing Shi, Shylaja Srinivasan, Jianfeng Xu, Jose C. Florez, Miriam S. Udler

Partitioned polygenic scores (pPS) have been developed to capture pathophysiologic processes underlying type 2 diabetes (T2D). We investigated the influence of T2D pPS on diabetes-related traits and T2D incidence in the Diabetes Prevention Program. We generated five T2D pPS (β-cell, proinsulin, liver/lipid, obesity, lipodystrophy) in 2,647 participants randomized to intensive lifestyle, metformin or placebo arms. Associations were tested using general linear models and Cox regression adjusted for age, sex, and principal components. Sensitivity analyses included adjustment for BMI. Higher β-cell pPS was associated with lower insulinogenic index and corrected insulin response at one year follow-up adjusted for baseline measures (effect per pPS standard deviation (SD) -0.04, P=9.6 x 10-7; -8.45 uU/mg, P=5.6 x 10-6, respectively) and with increased diabetes incidence adjusted for BMI at nominal significance (HR 1.10 per SD, P=0.035). The liver/lipid pPS was associated with reduced one-year baseline-adjusted triglyceride levels (effect per SD -4.37, P=0.001). There was no significant interaction between T2D pPS and randomized groups. The remaining pPS were associated with baseline measures only. We conclude that despite interventions for diabetes prevention, participants with a high genetic burden of the β-cell cluster pPS had worsening in measures of β-cell function.

Funding

L.K.B. is supported by the NorthShore Auxiliary Scholars Award. M.S.U. was supported by NIH/NIDDK K23DK114551. J.M. was partially supported by the American Diabetes Association (7-21-JDFM-005), the Nutrition Obesity Research Center at Harvard (P30 DK040561), and the NIH UG1 HD107691. S.R. is supported by a Webb Waring Biomedical Research Award from the Boettcher Foundation and by US Department of Veterans Affairs award IK2-CX001907. J.M.M. is supported by American Diabetes Association grant #11-22-ICTSPM-16 and by NHGRI U01HG011723. A.H. is supported by American Diabetes Association grant #11-23-PDF-35. J.C.F. is supported by NIH/NHLBI K24 HL157960. Genotyping in the DPP was supported by NIH/NIDDK R01 DK072041 to J.C.F. The DPP Research Group gratefully acknowledges the commitment and dedication of the participants of the DPP and DPPOS. Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) under award numbers U01 DK048489, U01 DK048339, U01 DK048377, U01 DK048349, U01 DK048381, U01 DK048468, U01 DK048434, U01 DK048485, U01 DK048375, U01 DK048514, U01 DK048437, U01 DK048413, U01 DK048411, U01 DK048406, U01 DK048380, U01 DK048397, U01 DK048412, U01 DK048404, U01 DK048387, U01 DK048407, U01 DK048443, and U01 DK048400, by providing funding during DPP and DPPOS to the clinical centers and the Coordinating Center for the design and conduct of the study, and collection, management, analysis, and interpretation of the data. Funding was also provided by the National Institute of Child Health and Human Development, the National Institute on Aging, the National Eye Institute, the National Heart Lung and Blood Institute, the National Cancer Institute, the Office of Research on Women’s Health, the National Institute on Minority Health and Health Disparities, the Centers for Disease Control and Prevention, and the American Diabetes Association. Genetic analy

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