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Genetics of diabetes-associated microvascular complications

Lyssenko, Valeriya LU and Vaag, Allan LU (2023) In Diabetologia 66(9). p.1601-1613
Abstract

Diabetes is associated with excess morbidity and mortality due to both micro- and macrovascular complications, as well as a range of non-classical comorbidities. Diabetes-associated microvascular complications are those considered most closely related to hyperglycaemia in a causal manner. However, some individuals with hyperglycaemia (even those with severe hyperglycaemia) do not develop microvascular diseases, which, together with evidence of co-occurrence of microvascular diseases in families, suggests a role for genetics. While genome-wide association studies (GWASs) produced firm evidence of multiple genetic variants underlying differential susceptibility to type 1 and type 2 diabetes, genetic determinants of microvascular... (More)

Diabetes is associated with excess morbidity and mortality due to both micro- and macrovascular complications, as well as a range of non-classical comorbidities. Diabetes-associated microvascular complications are those considered most closely related to hyperglycaemia in a causal manner. However, some individuals with hyperglycaemia (even those with severe hyperglycaemia) do not develop microvascular diseases, which, together with evidence of co-occurrence of microvascular diseases in families, suggests a role for genetics. While genome-wide association studies (GWASs) produced firm evidence of multiple genetic variants underlying differential susceptibility to type 1 and type 2 diabetes, genetic determinants of microvascular complications are mostly suggestive. Identified susceptibility variants of diabetic kidney disease (DKD) in type 2 diabetes mirror variants underlying chronic kidney disease (CKD) in individuals without diabetes. As for retinopathy and neuropathy, reported risk variants currently lack large-scale replication. The reported associations between type 2 diabetes risk variants and microvascular complications may be explained by hyperglycaemia. More extensive phenotyping, along with adjustments for unmeasured confounding, including both early (fetal) and late-life (hyperglycaemia, hypertension, etc.) environmental factors, are urgently needed to understand the genetics of microvascular complications. Finally, genetic variants associated with reduced glycolysis, mitochondrial dysfunction and DNA damage and sustained cell regeneration may protect against microvascular complications, illustrating the utility of studies in individuals who have escaped these complications.

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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diabetes, DNA, Genetics, Intrauterine programming, Metabolism, Microvascular diseases, Nephropathy, Neuropathy, Retinopathy, Review
in
Diabetologia
volume
66
issue
9
pages
13 pages
publisher
Springer
external identifiers
  • pmid:37452207
  • scopus:85164821410
ISSN
0012-186X
DOI
10.1007/s00125-023-05964-x
language
English
LU publication?
yes
id
46def17d-aac7-4bea-b838-7d9a8f16d6f6
date added to LUP
2023-09-27 11:35:23
date last changed
2024-04-19 02:45:46
@article{46def17d-aac7-4bea-b838-7d9a8f16d6f6,
  abstract     = {{<p>Diabetes is associated with excess morbidity and mortality due to both micro- and macrovascular complications, as well as a range of non-classical comorbidities. Diabetes-associated microvascular complications are those considered most closely related to hyperglycaemia in a causal manner. However, some individuals with hyperglycaemia (even those with severe hyperglycaemia) do not develop microvascular diseases, which, together with evidence of co-occurrence of microvascular diseases in families, suggests a role for genetics. While genome-wide association studies (GWASs) produced firm evidence of multiple genetic variants underlying differential susceptibility to type 1 and type 2 diabetes, genetic determinants of microvascular complications are mostly suggestive. Identified susceptibility variants of diabetic kidney disease (DKD) in type 2 diabetes mirror variants underlying chronic kidney disease (CKD) in individuals without diabetes. As for retinopathy and neuropathy, reported risk variants currently lack large-scale replication. The reported associations between type 2 diabetes risk variants and microvascular complications may be explained by hyperglycaemia. More extensive phenotyping, along with adjustments for unmeasured confounding, including both early (fetal) and late-life (hyperglycaemia, hypertension, etc.) environmental factors, are urgently needed to understand the genetics of microvascular complications. Finally, genetic variants associated with reduced glycolysis, mitochondrial dysfunction and DNA damage and sustained cell regeneration may protect against microvascular complications, illustrating the utility of studies in individuals who have escaped these complications. <br/></p>}},
  author       = {{Lyssenko, Valeriya and Vaag, Allan}},
  issn         = {{0012-186X}},
  keywords     = {{Diabetes; DNA; Genetics; Intrauterine programming; Metabolism; Microvascular diseases; Nephropathy; Neuropathy; Retinopathy; Review}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1601--1613}},
  publisher    = {{Springer}},
  series       = {{Diabetologia}},
  title        = {{Genetics of diabetes-associated microvascular complications}},
  url          = {{http://dx.doi.org/10.1007/s00125-023-05964-x}},
  doi          = {{10.1007/s00125-023-05964-x}},
  volume       = {{66}},
  year         = {{2023}},
}