Abstract

To clarify the effect of retinoid X receptor-α/γ (RXR-α/γ) genes functional genetic variants (RXR-α rs4842194 G>A, RXR-γ rs100537 A>G and rs2134095 T>C) on the risk of gestational diabetes mellitus (GDM), a case–control study with 573 GDM patients and 740 pregnant women with normal glucose tolerance was performed in Guangxi area of China. An odds ratio (OR) with its corresponding 95% confidence interval (CI) was used to assess the strengths of the association between genetic variation and GDM. After adjustment of age and pre-BMI, the logistic regression analysis showed that the rs2134095 was significantly associated with GDM risk (CC vs. TT/TC: adjusted OR = 0.71, 95% CI = 0.56–0.90) in all subjects, and this result remained highly significant after Bonferroni’s correction for multiple testing (P=0.004). The stratified analysis showed that rs2134095 was significantly associated with the risk of GDM among age > 30 years (adjusted OR = 0.61, 95% CI = 0.39–0.97), BMI > 22 kg/m2 (adjusted OR = 0.46, 95% CI = 0.30–0.70), systolic blood pressure (SBP) > 120 mmHg (adjusted OR = 1.96, 95% CI = 1.14–3.36), glycosylated hemoglobin A1c (HbA1c) < 6.5% (adjusted OR = 1.41, 95% CI = 1.11–1.78), TG ≤ 1.7 mmol/l (adjusted OR = 2.57, 95% CI = 1.45–4.53), TC ≤ 5.18 mmol/l (adjusted OR = 1.58, 95% CI = 1.13–2.22), high-density lipoprotein cholesterol (HDL-c) ≤ 1.5 mmol/l (adjusted OR = 1.70, 95% CI = 1.16–2.49) and low-density lipoprotein cholesterol (LDL-c) > 3.12 mmol/l (adjusted OR = 1.47, 95% CI = 1.08–2.00) subjects, under the recessive genetic model. We also found that rs2134095 interacted with age (Pinteraction=0.039), pre-BMI (Pinteraction=0.040) and TG (Pinteraction=0.025) influencing individual’s genetic susceptibility to GDM. The rs2134095 T>C is significantly associated with the risk of GDM by effect of a single locus and/or complex joint gene–gene and gene–environment interactions. Larger sample-size and different population studies are required to confirm the findings.

Highlights

  • Gestational diabetes mellitus (GDM) is defined as different degrees of impaired glucose tolerance that is first recognized during pregnancy, often manifested as insufficient islet secretion and insulin resistance, which seriously threatens maternal and child health [1]

  • The results showed that the genotype frequencies of rs4842194 G>A, rs100537 A>G and rs2134095 T>C were in agreement with Hardy–Weinberg equilibrium (HWE) in the controls (P>0.05), and the P-values were 0.727, 0.668 and 0.418, respectively

  • A multivariable logistic regression analysis adjusted for age and BMI showed that the rs2134095 T>C in retinoid acid X receptor (RXR)-γ gene was significantly associated with the risk of GDM, individuals with CT genotype were 1.32-times higher than those with TT genotype

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Summary

Introduction

Gestational diabetes mellitus (GDM) is defined as different degrees of impaired glucose tolerance that is first recognized during pregnancy, often manifested as insufficient islet secretion and insulin resistance, which seriously threatens maternal and child health [1]. Worldwide, it affects approximately 2–20% of all pregnancies [2]. The RXRs are nuclear receptors that mediate the biological effects of retinoids by their involvement in retinoic acid-mediated genes activation It functions as transcription factors by binding as heterodimers to the specific sequences in the promoter of target genes. It is reasonable to believe that RXRs play a key role in the pathogenesis of GDM

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