Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus

Abstract Background Diabetes mellitus (DM) can lead to microvascular and macrovascular damages through hyperglycemia that is the main cause of diabetic complications. Other factors such as hypertension, obesity, and hyperlipidemia may worsen or accelerate the others. Several studies have revealed de...

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Main Authors: Fatma A. Khalaf, Hatem R. Ibrahim, Hanan M. Bedair, Maha M. Allam, Amr A. Elshormilisy, Samia T. Ali, Waseem M. Gaber
Format: Article
Language:English
Published: SpringerOpen 2019-10-01
Series:Egyptian Journal of Medical Human Genetics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s43042-019-0018-1
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author Fatma A. Khalaf
Hatem R. Ibrahim
Hanan M. Bedair
Maha M. Allam
Amr A. Elshormilisy
Samia T. Ali
Waseem M. Gaber
author_facet Fatma A. Khalaf
Hatem R. Ibrahim
Hanan M. Bedair
Maha M. Allam
Amr A. Elshormilisy
Samia T. Ali
Waseem M. Gaber
author_sort Fatma A. Khalaf
collection DOAJ
description Abstract Background Diabetes mellitus (DM) can lead to microvascular and macrovascular damages through hyperglycemia that is the main cause of diabetic complications. Other factors such as hypertension, obesity, and hyperlipidemia may worsen or accelerate the others. Several studies have revealed definitive genetic predispositions to the development of type 2 diabetes mellitus (T2DM) and development of vascular complications. This study aimed to address the association between plasminogen activator inhibitor-1 (PAI-1) gene polymorphism and T2DM, and if this gene polymorphism may have a possible role in the development of vascular complications in T2DM. This study is a case control; it included 200 patients with T2DM, 117 patients had no vascular complications, and 83 had previous vascular complications (VCs). One hundred eighty volunteer blood donors were selected as a healthy control group. All patients and controls were subjected to clinical examination, and laboratory investigations included lipid profile, fasting and 2 h blood glucose, complete blood cell count, d-dimer, PAI-1, thrombin activatable fibrinolysis inhibitor (TAFI), and detection of PAI-1 gene polymorphism by real-time polymerase chain reaction (PCR). Results The most prevalent genotype of PAI-1 gene polymorphism in all studied groups, including controls, was 4G/5G with the highest allele frequency as 4G. The 4G/5G and 4G/4G genotypes were associated with increased risk of DM development as compared to 5G/5G genotype. The 4G/5G and 4G/4G genotypes also had a highly significant increased risk of VCs among diabetic patients, as compared to 5G/5G. The 4G allele also was highly associated with DM with VCs. The d-dimer TAFI, PAI-1 showed the highest levels in 4G/5G genotype followed by 4G/4G genotype. The lowest level was expressed in 5G/5G genotype in diabetic patients with and without VCs. The univariable analysis showed that genotypes 4G/5G and 4G/4G were potentially risk factors for development of VCs with T2DM patients. Conclusion This study concludes that the PAI-1 4G/5G polymorphism may be associated with T2DM and may be considered as a risk factor for development of thrombotic events. It may also help in selection and dosing of patients being treated with anticoagulant and fibrinolytic agents. Further large-scale studies are recommended to assess the possible role of environmental factors and gene interactions in the development of T2DM vascular risks.
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spelling doaj.art-7e4468ce07864286b2fd6aedf08447862022-12-21T21:48:46ZengSpringerOpenEgyptian Journal of Medical Human Genetics2090-24412019-10-0120111310.1186/s43042-019-0018-1Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitusFatma A. Khalaf0Hatem R. Ibrahim1Hanan M. Bedair2Maha M. Allam3Amr A. Elshormilisy4Samia T. Ali5Waseem M. GaberDepartment of Clinical biochemistry, National Liver Institute-Menoufia UniversityDepartment of Clinical Pathology, National Liver Institute-Menoufia UniversityDepartment of Clinical Pathology, National Liver Institute-Menoufia UniversityDepartment of Clinical Pathology, National Liver Institute-Menoufia UniversityInternal Medicine, Faculty of Medicine, Helwan UniversityInternal Medicine, Faculty of Medicine for girls, AL-Azhar UniversityAbstract Background Diabetes mellitus (DM) can lead to microvascular and macrovascular damages through hyperglycemia that is the main cause of diabetic complications. Other factors such as hypertension, obesity, and hyperlipidemia may worsen or accelerate the others. Several studies have revealed definitive genetic predispositions to the development of type 2 diabetes mellitus (T2DM) and development of vascular complications. This study aimed to address the association between plasminogen activator inhibitor-1 (PAI-1) gene polymorphism and T2DM, and if this gene polymorphism may have a possible role in the development of vascular complications in T2DM. This study is a case control; it included 200 patients with T2DM, 117 patients had no vascular complications, and 83 had previous vascular complications (VCs). One hundred eighty volunteer blood donors were selected as a healthy control group. All patients and controls were subjected to clinical examination, and laboratory investigations included lipid profile, fasting and 2 h blood glucose, complete blood cell count, d-dimer, PAI-1, thrombin activatable fibrinolysis inhibitor (TAFI), and detection of PAI-1 gene polymorphism by real-time polymerase chain reaction (PCR). Results The most prevalent genotype of PAI-1 gene polymorphism in all studied groups, including controls, was 4G/5G with the highest allele frequency as 4G. The 4G/5G and 4G/4G genotypes were associated with increased risk of DM development as compared to 5G/5G genotype. The 4G/5G and 4G/4G genotypes also had a highly significant increased risk of VCs among diabetic patients, as compared to 5G/5G. The 4G allele also was highly associated with DM with VCs. The d-dimer TAFI, PAI-1 showed the highest levels in 4G/5G genotype followed by 4G/4G genotype. The lowest level was expressed in 5G/5G genotype in diabetic patients with and without VCs. The univariable analysis showed that genotypes 4G/5G and 4G/4G were potentially risk factors for development of VCs with T2DM patients. Conclusion This study concludes that the PAI-1 4G/5G polymorphism may be associated with T2DM and may be considered as a risk factor for development of thrombotic events. It may also help in selection and dosing of patients being treated with anticoagulant and fibrinolytic agents. Further large-scale studies are recommended to assess the possible role of environmental factors and gene interactions in the development of T2DM vascular risks.http://link.springer.com/article/10.1186/s43042-019-0018-1Plasminogen activator inhibitor-1PolymorphismDiabetes mellitus
spellingShingle Fatma A. Khalaf
Hatem R. Ibrahim
Hanan M. Bedair
Maha M. Allam
Amr A. Elshormilisy
Samia T. Ali
Waseem M. Gaber
Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
Egyptian Journal of Medical Human Genetics
Plasminogen activator inhibitor-1
Polymorphism
Diabetes mellitus
title Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
title_full Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
title_fullStr Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
title_full_unstemmed Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
title_short Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
title_sort plasminogen activator inhibitor 1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus
topic Plasminogen activator inhibitor-1
Polymorphism
Diabetes mellitus
url http://link.springer.com/article/10.1186/s43042-019-0018-1
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