Abstract
BackgroundType 2 diabetes mellitus (T2DM) is a multifactorial disease where both genetic and environmental factors contribute to its pathogenesis. The PvuII and XbaI polymorphisms of the estrogen receptor 1 (ESR1) gene have been variably associated with T2DM in several populations. This association has not been studied in the Palestinian population. Therefore, the aim of this study was to investigate the association between the PvuII and XbaI variants in the ESR1 and T2DM and its related metabolic traits among Palestinian women.MethodsThis case–control study included 102 T2DM and 112 controls in which PvuII and XbaI variants of the ESR1 gene were genotyped using amplicon based next generation sequencing (NGS).ResultsAllele frequencies of both PvuII and XbaI variants were not significantly different between patients and control subjects (P > 0.05). In logestic regression analysis adjusted for age and BMI, the ESR1 PvuII variant was associated with risk of T2DM in three genotypic models (P < 0.025) but the strongest association was observed under over-dominant model (TT+CC vs. TC) (OR = 2.32, CI [1.18–4.55] adjusted P = 0.013). A similar but non-significant trend was also observed for the ESR1 XbaI variant under the over-dominant model (AA+GG vs. AG) (OR = 2.03, CI [1.05–3.95]; adjusted P = 0.035). The frequencies of the four haplotypes (TA, CG, CA, TG) were not significantly different in the T2DM patients compared with control group (P > 0.025). Among diabetic group, an inverse trend with risk of cardio vascular diseases was shown in carriers of CG haplotype compared to those with TA haplotype (OR = 0.28, CI [0.09–0.90]; adjusted P = 0.035). Further, stratified analyses based on ESR1 PvuII and XbaI genotypes revealed no evidence for association with lipid levels (TC, TG, HDL, LDL).ConclusionsThis is the first Palestinian study to conclude that ESR1 PuvII and XbaI variants may contribute to diabetes susceptibility in Palestinian women. Identification of genetic risk markers can be used in defining high risk subjects and in prevention trials.
Highlights
Type 2 diabetes mellitus (T2DM) is a multifactorial disease that caused by a complex combination of genetic and environmental factors
Our results showed that the heterozygous genotypes TC and AG of the estrogen receptor 1 (ESR1) PvuII and XbaI polymorphisms were significantly elevated in T2DM patients compared with control individuals (P = 0.04, P = 0.01, respectively), while, the frequencies of C and G alleles of the ESR1 PvuII and XbaI polymorphisms, respectively, were comparable among cases and controls (P > 0.05) (Table 2)
Not all studies are in agreement, PvuII and XbaI and other polymorphisms across the ESR1 gene have been associated with risk of T2DM as reported in the Chinese (Huang et al, 2006), African–Americans, European–Americans (Sale et al, 2004), Hungarians (Speer et al, 2001), and Egyptian women (Motawi et al, 2015)
Summary
Type 2 diabetes mellitus (T2DM) is a multifactorial disease that caused by a complex combination of genetic and environmental factors. Identification of genetic polymorphisms associated with diabetes may lead to prediction of disease development and prevention of its vascular complications (Slominski et al, 2018). Estrogen receptor 1 (ESR1) is broadly expressed in adipose tissue, skeletal muscle, liver, and immune cells It is a ligand-activated transcription factor that regulates a large number of genes in diverse target tissues (Hevener et al, 2018). The PvuII and XbaI polymorphisms of the estrogen receptor 1 (ESR1) gene have been variably associated with T2DM in several populations. This association has not been studied in the Palestinian population. Identification of genetic risk markers can be used in defining high risk subjects and in prevention trials
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