HindIII Polymorphism Research Articles

Functional significance of lipoprotein lipase HindIII polymorphism associated with the risk of coronary artery disease

Lipoprotein lipase (LPL) plays a pivotal role in lipid metabolism by hydrolyzing triglyceride (TG)-rich lipoprotein particles. Abnormalities in normal LPL function are associated with the risk of coronary artery disease (CAD). A number of genetic variants have been identified in the LPL gene that affects different functions of the LPL protein. A common HindIII polymorphism in intron 8 (T/G) of the LPL gene has been found to be associated with altered plasma TG and HDL-cholesterol, and CAD risk in several studies, but its functional significance is unknown. It has been shown that certain intronic sequence contain regulatory elements that are important for transcription and translational regulation of a gene. In this study we tested the hypothesis that this polymorphism affects the binding site of a transcription factor that regulates the transcription of LPL gene. Electrophoretic mobility shift assays (EMSAs) revealed that the HindIII site binds to a transcription factor and that the mutant allele has lower binding affinity than the wild type allele. Transcription assays containing the entire intron 8 sequence along with full-length human LPL promoter were carried out in COS-1 and human vascular smooth muscle cells. The mutant allele was associated with significantly decreased luciferase expression level compared to the wild type allele in both the muscle (3.394 ± 0.022 vs. 4.184 ± 0.028; P = 4.7 × 10 −6) and COS-1 (11.603 ± 0.409 vs. 14.373 ± 1.096; P < 0.0001) cells. In conclusion, this study demonstrates for the first time that the polymorphic HindIII site in the LPL gene is functional because it affects the binding of a transcription factor and it also has an impact on LPL expression.

HindIII Polymorphism in Carrier Detection of Hemophilia A in India: A New Primer Design

HindIII polymorphism studies were done in 67 north Indian families with hemophilia A using a new primer sequence and comparing results with the standard protocol. Amplified segment was 608 bp in size. Genetically positive hemizygous males (+) and homozygous females (+/+) showed 427, 100, and 81 size fragments, whereas heterozygous females (+/-) had 427, 181, 100, and 81-bp segments. Genotypically negative hemizygous (-) males and homozygous females (-/-) show that 427-bp and 181-bp fragments dimer formation was minimal and results matched with standard protocol in 20 cases where both polymerase chain reactions were run. The frequency of positive allele for HindIII polymorphism in 67 families was 0.38 and heterozygosity in terms of informativity was 0.46.

Lipoprotein lipase HindIII polymorphism influences HDL-cholesterol levels in statin-treated patients with coronary artery disease

HDL-cholesterol (HDL-C) is a recognized athero-protective factor and low levels of HDL-C occur frequently in patients with coronary artery disease. Regulation of HDL-C level most probably results from the interaction of genes involved in lipoprotein metabolism and also from non-genetic factors. We studied associations and interactions among HindIII polymorphisms of the lipoprotein lipase gene LPL and selected non-genetic factors with respect to HDL-C levels in patients with coronary artery disease. 288 Slovak patients (35% women) with documented coronary artery disease, age (mean +/- SEM) 60 +/- 1 years and BMI 29 +/- 0.3 kg/m(2), were examined and genotyped for LPL HindIII (rs320) using a PCR/RFLP method. HDL-C levels were determined in a direct enzymatic assay. In the sample overall there were no significant differences across the LPL genotypes in adjusted HDL-C levels or in other lipids, although a trend toward higher HDL-C and lower triglycerides in H-H- homozygotes was observed. Multiple linear regression identified a significant interaction between LPL HindIII and statin treatment, which together with sex and diabetes explained 12.1% of HDL-C variance. Accordingly, in statin-treated patients we observed significant stepwise increments of the HDL-C level related to the increasing number of H- alleles (P = 0.04 for linear trend), whereas no such association was observed in patients without hypolipidemic treatment. H-H- homozygotes had a 16% (0.19 mmol/l) higher level of HDL-C than the H+H+ homozygotes (P = 0.06). HDL-C may be influenced by an interaction between statin treatment and LPL HindIII genotype. However, the effect of this interaction appears to be small when compared with the effect of non-genetic factors. This finding requires replication in a pharmacogenetic study.

Intraspecific variation and population structure of the German cockroach,Blattella germanica, revealed with RFLP analysis of the non‐transcribed spacer region of ribosomal DNA

Little information is available on genetic variation within and between populations of pest cockroaches. In this study, intraspecific HindIII polymorphism was investigated in the German cockroach, Blattella germanica (Linnaeus) (Dictyoptera, Blattaria: Blattellidae), using restriction fragment length polymorphisms (RFLP) of the non-transcribed spacer (NTS) region of ribosomal DNA (rDNA). Individual male insects were collected from infestations at three different pig farms. Each population was characterized by HindIII restriction fragment frequencies and haplotype (a particular X-chromosome pattern) frequencies. The inheritance of the X-chromosome HindIII rDNA patterns over 12 generations (3 years) follows Mendelian patterns, and the stability of this polymorphic marker indicates infrequent genetic recombination of variable sites. Although pairwise genetic distance measures were uncorrelated with geographical distance, the pattern of genetic differentiation of the three cockroach populations suggests that human-mediated transport of cockroaches is an important force in shaping the population genetic structure of cockroach infestations, at least at the regional scale of 10-100 km. Sequence variation in the ribosomal NTS is a useful marker, and RFLP of rDNA is a simple, robust and reproducible technique for differentiating recently diverged cockroach populations.

Analysis of the AluI polymorphism in intron 1 of the human coagulation factor VIII gene: A new marker for the hemophilia a carrier detection

Frequencies of the CIT SNP alleles at position 2403 of the human coagulation factor VIII gene intron 1, containing the AluI restriction endonuclease recognition site, were examined. Genomic DNA samples for the analysis were obtained from the consulted women and their relatives from the families with hemophilia A. A total of 221 unrelated X chromosomes were studied. The two allelic variants were found with similar frequencies of T(Alu+), 0.53 and C(Alu-), 0.47. The heterozygosity index evaluated as equal to 0.50 was correlated with the experimental heterozygote number. The absence of a tight linkage between the AluI SNP and the widely used in the hemophilia A gene diagnostics HindIII polymorphism (CIT SNP at position 103 of intron 19) was demonstrated. Summarized informativity of these two markers for obligate carriers and for those detected in this study constituted 68% (32 out of 47). At the same time using one of the markers, only 40% (HindIII) and 51% (AluI) of the consulted women were informative. The new marker was used in 13 prenatal DNA diagnostics of hemophilia A. A new deletion polymorphism (del TGA, position 2281-2283 of intron 1) was described in close proximity of the AluI SNP with the frequency of about 0.05. among the five other SNP of the factor VIII gene examined (Bme 18I, intron 1; HpaII, intron 13; MnlI, exon 14; Bst4CI, exon 25; and MseI, exon 26) no effective diagnostic markers were found. Only the MnlI polymorphism could be recommended for limited usage.

Association of lipase lipoprotein polymorphisms with myocardial infarction and lipid levels

Lipoprotein lipase has an important role in lipid metabolism. Elevated levels of very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) are associated with increased risk of coronary artery disease and low levels of high-density lipoprotein (HDL) are potentially atherogenic. The HindIII and S447X polymorphisms of the lipoprotein lipase (LPL) gene are associated with cardiovascular disease in some populations. LPL HindIII and S447X polymorphisms were analyzed in 343 individuals of 66-97 years of age from a cohort of a Brazilian elderly longitudinal study. Allele frequencies, genotype distribution and allele association with major morbidities and with serum lipid, urea, creatinine and albumin levels were also investigated. The whole sample was genotyped by PCR-restriction fragment length polymorphism (RFLP). Descriptive statistics, logistic regression analysis and t-test were used. Allele frequencies were H(+)=0.652 and H(-)=0.348 for LPL HindIII and S=0.824 and X=0.176 for LPL S447X polymorphism. Both polymorphisms have frequencies similar to those in some European populations. LPL HindIII polymorphism showed significant association of the H(+) allele with myocardial infarction. The H(-) allele showed a tendency to associate with higher HDL levels. The LPL S447X S allele was associated with higher triglyceride levels. These findings may help to identify risk factors for subjects and families and clarify the physiopathological role of these polymorphisms in age-related diseases.

Association of lipoprotein receptor, receptor-associated protein, and metabolizing enzyme gene polymorphisms with gallstone disease: A case–control study

To identify high risk alleles for gallstone disease, we analyzed association of LDLRAvaII, LRPAP1 insertion/deletion, CETPTaqI B, and LPLHindIII polymorphisms with gallstone disease. In DNA samples of 214 gallstone patients and 322 age and sex matched controls, specific region containing polymorphisms was PCR amplified and digested with restriction enzymes except for LRPAP1 insertion/deletion polymorphism. LRPAP1 gene insertion/deletion polymorphism was found to be significantly associated with gallstone disease. Genotype II was conferring significant risk for gallstone disease in females only (P=0.019; OR 2.577, 95% CI 1.144-5.806). LDLRAvaII, CETPTaqI B, and LPLHindIII polymorphisms were not found to be associated with gallstone disease either at genotype or allele level. LRPAP1, II genotype carrier females may have increased risk for gallstone disease. On the other hand, LDLR AvaII, CETP TaqI B, and LPL HindIII polymorphisms may not be associated with gallstone disease.

HindIII(+/−) Polymorphism of the Y Chromosome, Blood Pressure, and Serum Lipids: No Evidence of Association in Three White Populations

Male sex is associated with elevated levels of cardiovascular risk factors, including higher blood pressure (BP). Genetic variants on the Y chromosome may contribute to explain the sexual dimorphism in cardiovascular diseases. Among them, the HindIII(+/-) polymorphism of the male-specific region of the Y chromosome has been associated with BP and serum cholesterol levels, with conflicting results. We evaluated the association between the HindIII(+/-) polymorphism, prevalence of hypertension, BP, and serum lipid levels in a large sample of white men and the previously reported epistatic interaction between HindIII(+/-) and the -344C/T polymorphism of the aldosterone synthase gene (CYP11B2) on BP. From three European populations (UK n = 422; Belgium n = 313; Italy n = 1248) 1983 white men were phenotyped for BP and serum lipids and genotyped for HindIII(+/-) site and for -344C/T polymorphism in the promoter of CYP11B2 by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). A higher frequency of the HindIII (+) was found in Italians (63%) as compared to both British (31%) and Belgians (28%) (P < .0001). We found no evidence of association of the HindIII(+/-) site with prevalence of hypertension, BP, and serum lipids in any of the three European populations examined and in the entire sample. Finally, we did not observe any interaction between the HindIII(+/-) polymorphism and the -344C/T variant of CYP11B2 on BP. Our data do not support the hypothesis that the HindIII(+/-) site of the Y chromosome is a marker of cardiovascular risk in white men, highlighting the need for replication in genetic association studies.

Effect of gene polymorphisms on lipoprotein levels in patients with dyslipidemia of metabolic syndrome

Dyslipidemia in the metabolic syndrome (MS) is considered to be one of the most important risk factors for atherosclerosis. It is characterized by hypertriglyceridemia, low concentration of plasma HDL-cholesterol, predominance of small dense LDL particles and an increased concentration of plasma apolipoprotein B (apoB). The pathogenesis of this type of dyslipidemia is partially explained, but its genetic background is still unknown. To evaluate the influence of cholesterol ester transfer protein (CETP) TaqIB polymorphism, lipoprotein lipase (LPL) PvuII and HindIII polymorphisms, hepatic lipase (LIPC) G-250A polymorphism and apolipoprotein C-III (APOC3) SstI gene polymorphism on lipid levels in dyslipidemia of the metabolic syndrome, 150 patients with dyslipidemia of metabolic syndrome were included. 96 % of patients had type 2 diabetes. The patients did not take any lipid lowering treatment. The exclusion criterion was the presence of any disease that could affect lipid levels, such as thyroid disorder, liver disease, proteinuria or renal failure. Gene polymorphisms were determined using the polymerase chain reaction and restriction fragment length polymorphisms. The genotype subgroups of patients divided according to examined polymorphisms did not differ in plasma lipid levels with the exception of apoB. The apoB level was significantly higher in patients with S1S1 genotype of APOC3 SstI polymorphism when compared with S1S2 group (1.10+/-0.26 vs. 0.98+/-0.21 g/l, p=0.02). Similarly, patients with H-H- genotype of LPL HindIII polymorphism had significantly higher mean apoB, compared with H+H- and H+H+ group (1.35+/-0.30 vs. 1.10+/-0.26 g/l, p=0.02). In the multiple stepwise linear regression analysis, apoB level seemed to be influenced by APOC3 SstI genotype, which explained 6 % of its variance. The present study has shown that the S1 allele of APOC3 SstI polymorphism and the H- allele of LPL HindIII polymorphism might have a small effect on apoB levels in the Central European Caucasian population with dyslipidemia of metabolic syndrome.

Relationship between plasma HDL subclasses distribution and lipoprotein lipase gene HindIII polymorphism in hyperlipidemia

Background Different high-density lipoprotein (HDL) subclasses have distinct but interrelated metabolic functions. HDL directly influences the atherogenic process, and changes in HDL subclasses distribution may be related to the incidence and prevalence of atherosclerosis. Lipoprotein lipase (LPL) is an important enzyme for hydrolysis of triglyceride-rich lipoproteins, and its activity is positively correlated with the plasma HDL cholesterol level. LPL gene HindIII polymorphism has been found associated with variations in lipid levels, but the impact on HDL subclasses distribution is less clearly established. Methods The relative apolipoprotein (apo) A-I contents (% apoA-I) of plasma HDL subclasses were determined by two-dimensional gel electrophoresis coupled with immunodetection and LPL gene HindIII polymorphism was assayed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 173 hyperlipidemic and 155 normolipidemic subjects. Results The frequencies of 495TT genotype and allele T were the highest both in the hyperlipidemic and control groups. Compared with the control group, the frequency of 495TT genotype was higher, while the frequencies of 495TG and 495GG genotypes were significantly lower ( P < 0.05) in the hyperlipidemic group. Two-dimensional gel electrophoresis and immunodetection showed that HDL subclasses distribution was altered in hyperlipidemia, and had a general shift toward smaller size. Compared with the control group, the hyperlipidemic group had significantly higher relative apoA-I contents of preβ 1-HDL, preβ 2-HDL, HDL 3b and HDL 3a ( P < 0.05) and lower HDL 2a and HDL 2b levels ( P < 0.001). In the hyperlipidemic group, allele T carriers' frequency was higher than that in the control group ( P < 0.05), and the genotype of 495TT showed higher levels of plasma TG, apoB100, TG / HDL-C ratio, relative apoA-I contents of preβ 1-HDL, HDL 3b and lower HDL 2a, HDL 2b compared with that of the 495GG genotype subgroup ( P < 0.05). In the control group, the genotype of 495TT had higher plasma TG, HDL 3c and lower HDL 2a compared with that of 495GG subgroup ( P < 0.05). Conclusions The 495TT genotype of LPL gene HindIII polymorphism was associated with changes of HDL subclasses distribution in Chinese population with hyperlipidemia. The particle size of HDL shifted toward smaller, which, in turn, indicated that RCT might be weakened and HDL maturation might be abnormal in hyperlipidemic subjects with 495TT genotype.

Non-recombining chromosome Y haplogroups and centromeric HindIII RFLP in relation to blood pressure in 2,743 middle-aged Caucasian men from the UK

Evidence from rodents and association analyses in humans suggest the presence on chromosome Y of one or more genes affecting blood pressure (BP). The HindIII centromeric alphoid polymorphism has been reported to be associated with BP in three independent human populations, although other studies reported null associations with this trait. Our objective was to test for association between BP and genetic variation of the Y chromosome. To this end, 2,743 unrelated Caucasian men recruited from nine UK practices were analysed for five SNPs (including the HindIII site) and two microsatellites spanning the non-recombining region of the Y chromosome. Systolic and diastolic BP were analysed both as quantitative traits and as categorical variables. Differences between locations were tested. Haplotypic and linkage disequilibrium (LD) analyses were also performed. Overall, no significant association was found between any of the loci analysed and BP, although post hoc analyses suggest a possible relation of specific Y haplogroups to BP. The HindIII polymorphism marks major structural differences in the Y centromere which could influence mitotic loss during ageing, or other somatic events. However, this study does not support a causal effect on BP, although association of one or more Y haplogroups cannot be excluded.

Lipoprotein lipase locus and progression of atherosclerosis in coronary-artery bypass grafts

Purpose: Our aim was to test whether polymorphisms in the lipoprotein lipase (LPL) gene were associated with the progression of atherosclerosis in grafts examined in the Post-Coronary Artery Bypass Graft Trial (Post-CABG Trial).Methods: 843 subjects in the post-CABG trial were genotyped for the LPL-D9N, N291S, PvuII, (TTTA)n, and HindIII polymorphisms. Associations between genotype and angiographically measured progression of atherosclerosis in grafts, medical history, and family history were examined.Results: Greater progression of atherosclerosis was observed in subjects with LPL-HindIII 2/2 (56% versus 42% of those with other LPL HindIII genotypes, P = 0.025) and with LPL (TTTA)n 4/4 (63% versus 43% of those with other (TTTA)n genotypes, P = 0.020). Mantel-Haenszel analysis yielded an odds ratio of 1.84 for the effect of LPL HindIII 2/2 genotype on the progression of atherosclerosis in grafts (P = 0.015) and demonstrated that the effect of genotype on progression was of the same magnitude as, but independent of, the effect of drug treatment.Conclusion: The LPL-HindIII 2/2 genotype is a marker for genetic variation in the 3′-end of LPL that acts as an independent risk factor for the progression of atherosclerosis in grafts examined in the Post-CABG Trial.

Lack of association between the HindIII RFLP of the osteocalcin (BGP) gene and bone mineral density (BMD) in healthy pre- and postmenopausal Chinese women.

In Caucasian populations, the polymorphic restriction endonuclease HindIII marker of the osteocalcin (also known as BGP, for bone Gla protein) gene has recently been reported to be associated with bone mass, a major risk determinant of osteoporosis. In this study, we investigated the relationship between the BGP HindIII polymorphism and bone mineral density (BMD) in 388 premenopausal (31.18 +/- 5.92 years) and 169 postmenopausal (58.90 +/- 6.27 years) Chinese women. The BMD of spine and hip was measured by dual-energy X-ray absorptiometry (DEXA). All the study subjects were genotyped at the HindIII site of the BGP gene by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) detecting methods. The BGP alleles were designated according to the absence ( H) or presence ( h) of the HindIII restriction site. We did not find any significant difference in spine and hip BMD across BGP genotypes in either pre- or postmenopausal women or the combined group. Our result is not consistent with recent reports that the HindIII marker of the BGP gene is associated with osteoporosis. The different findings may reflect inter-population differences in the association (i.e., linkage disequilibrium) of molecular markers with BMD, and indicate the limit of using the HindIII marker of the BGP gene as a genetic marker to discern women susceptible to low BMD and thus osteoporosis in Chinese.

Association between genetic variation in the Y chromosome and hypertension in myocardial infarction patients.

A single nucleotide polymorphism (SNP) in chromosome Y has been associated with blood pressure. In men, the risk of suffering from cardiovascular diseases, including coronary artery disease, could be influenced by one or more loci on chromosome Y. We genotyped 208 men who had suffered an early episode of myocardial infarction (MI) (< or =55 years) and 178 healthy control men for two Y-polymorphisms (a HindIII polymorphism in an alphoid satellite in the centromeric non-recombining region and the -2627 T/C in the SRY gene). Frequencies were compared through a chi(2)-test. Frequencies for the two polymorphisms did not differ between patients and controls. The alphoid-HindIII polymorphism was not related to blood pressures in our population (HindIII+: diastolic, 80 +/- 2; systolic, 129 +/- 5. HindIII-: diastolic, 80 +/- 2; systolic, 128 +/- 3). Seventy-six patients (37%) were hypertensives and had a significantly higher frequency of the HindIII+ allele compared to the normotensive patients (46 and 26%, respectively; P = 0.028). According to our data, the alphoid-HindIII polymorphism in chromosome Y was not associated with differences in blood pressure in men from Asturias (Northern Spain). However, the HindIII+ allele increased the risk of suffering an early episode of MI among hypertensives.

The lipoprotein lipase gene HindIII polymorphism is associated with lipid levels in early-onset type 2 diabetic patients

Lipoprotein lipase (LPL) plays a central role in triglyceride metabolism, and the LPL gene T495G HindIII polymorphism has been associated with variations in lipid levels and heart disease in Caucasians with the more common H+ allele being associated with adverse lipid profiles and increased risk of CHD. We investigated this polymorphism in 785 Chinese subjects with varying components of the metabolic syndrome, including 61.4% with early-onset type 2 diabetes (age at diagnosis ≤ 40 years), and 167 healthy control subjects using a polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) method. The allele and genotype frequencies were similar in the patients and control subjects. When grouped above or below standard cutoffs for triglyceride levels, the H+ allele was more frequent in hypertriglyceridemic than that in normotriglyceridemic subjects in the total population (81.5% v 76.1%) and early-onset type 2 diabetics (84.4% v 77.4%, both P <.05). Moreover, H+H+ carriers had significantly higher plasma triglyceride and lower high-density lipoprotein (HDL)-cholesterol levels when compared to subjects with the H- allele in the total population, and in patients with early-onset diabetics (both P <.05). In the total population and the early-onset diabetic patients, this relationship was confined to males when gender was considered. We conclude that the H+ allele of the LPL gene HindIII polymorphism is associated with higher plasma triglyceride and lower HDL-cholesterol levels in Chinese patients with early-onset diabetes. Copyright 2003, Elsevier Science (USA). All rights reserved.

The 4G/5G promotor polymorphism of the PAl-1 gene is associated with coronary artery disease and linked to the HINDIII polymorphism

The 4G/5G promotor polymorphism of the PAl-1 gene is associated with coronary artery disease and linked to the HINDIII polymorphism

Genetics of the lipoprotein lipase gene and hypertriglyceridaemia

The aim of this study is to assess whether genetic variation at the lipoprotein lipase (LPL) gene is related to fasting triglyceride levels or to the presence of vascular disease. Hypertriglyceridaemic patients are genotyped for the N291S, G188E, and P207L variants and the HindIII and PvuII restriction fragment length polymorphisms of the LPL gene. Sequence analysis is carried out on exons 1–9 of the LPL gene for patients with severe hypertriglyceridaemia, to search for new gene variants. No differences were found between the patient and control group for the N291S, G188E and P207L variants. The HindIII and PvuII allelic frequencies were found to be similar for patients and controls; however, the frequency of the PvuII P2 allele was higher in patients with vascular disease (allele frequency: 0.56) than patients with no vascular disease (allele frequency, 0.42) (P=0.03). Sequence analysis revealed no exon sequence variants in the LPL gene but two intron sequence variants were found in intron 5 in two patients.

Osteocalcin gene HindIII C/T polymorphism is a biomarker for prostate cancer and responsiveness to hormone therapy.

Osteocalcin is a vitamin-K dependent protein which is related to the metabolism of bone and calcium. The formation or progression of prostate cancer is presumed to be associated with the osteocalcin gene. The most frequently seen polymorphism is HindIII which is located at the promoter region. HindIII is therefore a possible genetic marker in the search for the association between prostate cancer and normal control subjects. In our study, a normal control group of 132 healthy people and 96 patients with prostate cancer were examined. The polymorphism was seen following polymerase chain reaction (PCR) based restriction analysis. The result revealed significant differences between normal individuals and cancer patients (p=0.034) and the distribution of the "CC" homozygote in the control group was higher than that in the patient group. No statistical differences were found in clinical staging and grading. The 54 patients who received hormone therapy were further categorized into response and non-response groups, statistical differences between these two groups were revealed (p=0.007, Fisher's exact test). Based on our results, we conclude that the HindIII polymorphism of the osteocalcin gene is a suitable genetic marker of prostate cancer which can be used in the prediction of the outcome of patients who receive hormone therapy.

Factor VIII gene polymorphisms in North Indian population: a consensus algorithm for carrier analysis of hemophilia A

Background: Hemophilia A, an X-linked recessive disorder, has the prevalence of 1 male per 7000 of the male population in the Northern states of India. The aim of the present study was to analyze the polymorphisms of the factor VIII gene in a sample population comprised of 22 families (112 persons) in order to formulate an algorithm that would be informative and accurate, yet cost-effective for carrier diagnosis. Methods: Polymerase chain reaction was used to study the polymorphisms of two intragenic restriction fragment length polymorphic sites (recognized by BclI and HindIII) and an extragenic variable number tandem repeat (VNTR) locus (St14). Results: Fifty-eight percent of the women tested were heterozygous for the BclI restriction fragment length polymorphism (RFLP) (significantly high compared to earlier reports), signifying the usefulness of this marker in carrier detection. About 64% of the families from the target population could be diagnosed using this marker alone. The other intragenic HindIII RFLP site showed a heterozygosity rate of 43% in women, and was effective in diagnosing 50% of the families studied. The population prevalence for ‘+’ alleles of BclI and HindIII were 68% and 33%, respectively. About 88% of the women tested were heterozygous for the St14 locus, and 83% of the families could be diagnosed using this marker alone. The 1390- and 1300-bp alleles were most prevalent, while novel polymorphisms of 1500 and 1345 bp were detected. Conclusions: Based on the above data, we suggest screening hemophilic families first for BclI polymorphism, followed by an analysis for HindIII polymorphism in case of homozygosity at the BclI site. When both were noninformative, analysis of St14 locus would be necessary.

Nephropathy in type 1 diabetes: A manifestation of insulin resistance and multiple genetic susceptibilities?: Further evidence from the Pittsburgh Epidemiology of Diabetes Complication Study

The pathogenesis of diabetic nephropathy remains unclear, although previous reports implicate a wide range of putative genetic and metabolic factors. Incident and prevalent cases of overt nephropathy (ON), defined as an albumin excretion rate>200 microg/min in at least two of the three timed urines, from the Pittsburgh Epidemiology of Diabetes Complication Study (a prospective epidemiologic study of an incident cohort of childhood onset type 1 diabetic subjects) were studied. Incidence analyses reveal differences in univariate baseline risk factors that predict ON within 5 years of measurement [low-density lipoprotein (LDL) cholesterol, triglycerides, white blood cell count, and hypertension] and those that predict in the long-term, that is, 6 to 10 years after baseline, hemoglobin A1 (Hb A1). Estimated glucose disposal rate (calculated using a formula derived from euglycemic-hyperinsulinemic clamp studies), however, strongly (P < 0.001) predicted ON throughout follow-up. Comparing individuals who were most susceptible to ON (those with an onset before 20 years duration of type 1 diabetes and before the development of other advanced complications) with the least susceptible (late or no occurrence of ON despite the development of other advanced complications) revealed otherwise undetected genetic associations [that is, apolipoprotein E (Apo E), angtiotensin-converting enzyme insertion/deletion (ACE I/D), and lipoprotein lipase (LPL) HindIII polymorphism) with odds ratios ranging from 2.9 to 7.1. In type 1 diabetes insulin resistance is an underlying risk state for ON, which may be accelerated by other disturbances (for example, hypertension and dyslipidemia). A novel approach to classifying (that is, phenotyping) subjects, which compares those at the extremes of susceptibility, reveals strong genetic associations and important interactions with other risk factors not otherwise apparent.