1. The Low-Expression Variant of FABP4 Is Associated With Cardiovascular Disease in Type 1 Diabetes.
- Author
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Dahlström EH, Saksi J, Forsblom C, Uglebjerg N, Mars N, Thorn LM, Harjutsalo V, Rossing P, Ahluwalia TS, Lindsberg PJ, Sandholm N, and Groop PH
- Subjects
- Adult, Alleles, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Cohort Studies, Denmark epidemiology, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 epidemiology, Diabetic Angiopathies epidemiology, Diabetic Angiopathies genetics, Female, Finland epidemiology, Gene Expression Regulation, Genetic Association Studies, Genetic Predisposition to Disease, Humans, Male, Mendelian Randomization Analysis, Middle Aged, Polymorphism, Single Nucleotide, Risk Factors, Cardiovascular Diseases genetics, Diabetes Mellitus, Type 1 genetics, Fatty Acid-Binding Proteins genetics
- Abstract
Fatty acid binding protein 4 (FABP4) is implicated in the pathogenesis of cardiometabolic disorders. Pharmacological inhibition or genetic deletion of FABP4 improves cardiometabolic health and protects against atherosclerosis in preclinical models. As cardiovascular disease (CVD) is common in type 1 diabetes, we examined the role of FABP4 in the development of complications in type 1 diabetes, focusing on a functional, low-expression variant (rs77878271) in the promoter of the FABP4 gene. For this, we assessed the risk of CVD, stroke, coronary artery disease (CAD), end-stage kidney disease, and mortality using Cox proportional hazards models for the FABP4 rs77878271 in 5,077 Finnish individuals with type 1 diabetes. The low-expression G allele of rs77878271 increased the risk of CVD, independent of confounders. Findings were tested for replication in 852 Danish and 3,678 Finnish individuals with type 1 diabetes. In the meta-analysis, each G allele increased the risk of stroke by 26% ( P = 0.04), CAD by 26% ( P = 0.006), and CVD by 17% ( P = 0.003). In Mendelian randomization, a 1-SD unit decrease in FABP4 increased risk of CAD 2.4-fold. Hence, in contrast with the general population, among patients with type 1 diabetes the low-expression G allele of rs77878271 increased CVD risk, suggesting that genetically low FABP4 levels may be detrimental in the context of type 1 diabetes., (© 2021 by the American Diabetes Association.)
- Published
- 2021
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