Abstract
The increasing prevalence of type 2 diabetes among South Asians is caused by a complex interplay between environmental and genetic factors. We aimed to examine the impact of dietary and genetic factors on metabolic traits in 1062 Asian Indians. Dietary assessment was performed using a validated semi-quantitative food frequency questionnaire. Seven single nucleotide polymorphisms (SNPs) from the Transcription factor 7-like 2 and fat mass and obesity-associated genes were used to construct two metabolic genetic risk scores (GRS): 7-SNP and 3-SNP GRSs. Both 7-SNP GRS and 3-SNP GRS were associated with a higher risk of T2D (p = 0.0000134 and 0.008, respectively). The 3-SNP GRS was associated with higher waist circumference (p = 0.010), fasting plasma glucose (FPG) (p = 0.002) and glycated haemoglobin (HbA1c) (p = 0.000066). There were significant interactions between 3-SNP GRS and protein intake (% of total energy intake) on FPG (Pinteraction = 0.011) and HbA1c (Pinteraction = 0.007), where among individuals with lower plant protein intake (<39 g/day) and those with >1 risk allele had higher FPG (p = 0.001) and HbA1c (p = 0.00006) than individuals with ≤1 risk allele. Our findings suggest that lower plant protein intake may be a contributor to the increased ethnic susceptibility to diabetes described in Asian Indians. Randomised clinical trials with increased plant protein in the diets of this population are needed to see whether the reduction of diabetes risk occurs in individuals with prediabetes.
Highlights
South Asian populations have a 50% higher risk of type 2 diabetes (T2D) than other populations [1,2] and this has significant implications, as patients with T2D have a 2–4 times increased risk of cardiovascular diseases [1]
We found that the interactions between 3-single nucleotide polymorphisms (SNPs) genetic risk score (GRS) and dairy protein intake were not statistically significant (Pinteraction = 0.439 and 0.597 for HbA1c and fasting plasma glucose (FPG), respectively), suggesting that dairy protein intake is unlikely to confound the GRS–animal protein intake interaction on diabetes traits
Our study suggests that increasing the intake of plant protein might be an effective strategy towards better management of blood glucose levels, especially in Asian Indians with a higher genetic susceptibility for T2D
Summary
South Asian populations have a 50% higher risk of type 2 diabetes (T2D) than other populations [1,2] and this has significant implications, as patients with T2D have a 2–4 times increased risk of cardiovascular diseases [1]. The increasing prevalence of T2D among Asian Indians is caused by a complex interplay between environmental and genetic factors, including urbanisation, which plays a large role [8,9,10]. In South Asians, several single nucleotide polymorphisms (SNPs) have been associated with adiposity [20,21,22,23], insulin resistance [24], pancreatic β-cell function [20,25,26] and T2D [20,22,23,26,27]. Studies have reported strong associations of the Transcription factor 7-like 2 (TCF7L2) SNPs, rs7903146 and rs12255372, with T2D risk in Asian Indians [29,30,31]. Single genetic variants have only a small to moderate effect on disease risk, combining effects of several SNPs into a genetic risk score (GRS) is required for better detection of individuals with high risk of diabetes [36]
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