NEW YORK (Reuters Health) - Type 2, but not type 1, diabetic patents are less likely to develop diabetic neuropathy if they posses the Asp299Gly and Thr399II2 genotypes of the toll-like receptor 4 (TLR4) gene. This finding suggests that the “pathogenesis of diabetic neuropathy may partly differ between type 1 and type 2 diabetics,” the researchers note.
The TLR4 gene is a central regulator of the innate immune response, which is increasingly thought to play a role in late diabetic complications, Dr. Gottfried Rudofsky, Jr., from the University of Heidelberg in Germany and colleagues explain in the January issue of Diabetes Care.
To establish whether two common single nucleotide polymorphisms (Asp299Gly and Thr399II2) are associated with late diabetic complications, Dr. Rudofsky’s team studied 246 type 1 and 530 type 2 diabetic patients.
The prevalence of these two polymorphisms did not differ between the groups; in most cases the two alleles occurred in a “co-segregatory manner,” according to the team. The prevalence of the Asp299Gly/THr399IIe haplotype was 10.6% and 12.1% of type 1 and type 2 diabetics, respectively.
There was no association between these two polymorphisms and diabetic nephropathy or diabetic neuropathy in type 1 diabetic patients.
However, in type 2 diabetics, the prevalence of diabetic neuropathy was significantly reduced in heterozygote carriers of the Asp299Gly and Thr399Iie genotypes (odds ratio, 0.35). No association with diabetic nephropathy was evident in type 2 diabetics.
Dr. Rudofsky and colleagues say further research is needed, adding that they cannot tell from the current study whether the Asp299Gly/THr399IIe TLR4 allele is actually protective against diabetic neuropathy in type 2 diabetics.
Source: Diabetes Care 2004;27:179-183. [ Google search on this article ]
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