Some Diabetics at Higher Risk for Heart Disease
Reported December 04, 2008
(Ivanhoe Newswire) — The combination of genetics and glycemic control may make some diabetics more likely to have heart disease.
A new report from Harvard Medical School finds patients with type 2 diabetes who have poor glycemic control and a certain genetic variation are more at risk of coronary artery disease (CAD).
Genetic variation on chromosome 9p21 has been associated with increased risk of CAD in the general population. Researchers wanted to know how it affected type 2 diabetics and whether poor glycemic control made a difference. They conducted two studies — one included 734 patients with type 2 diabetes patients, 322 with CAD; 412 without. The other study had 475 patients with type 2 diabetes whose survival was monitored during the trial.
Results show the odds for CAD in patients with two risk gene variants but not poor glycemic control was increased two-fold while the odds for CAD among those with the same genotype but poor glycemic control was increased four-fold. The interaction was stronger when a measure of long-term glycemic control was used in patients with two risk gene variants and a history of poor glycemia and for those with the same genotype but not long-term poor glycemia.
There was also a similar interaction between the 9p21 variant and poor glycemic control with respect to the rate of death after 10 years.
The authors conclude, the 9p21 variant and poor glycemic control interact in determining the odds of CAD in type 2 diabetes. They say this finding may lead to a better understanding of how plaque forms in the arteries of diabetics and could help lead to better ways to prevent it.
SOURCE: JAMA, 2008;300:2389-2397