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Impact of TCF7L2 rs7903146 on clinical presentation and risk of complications in patients with type 2 diabetes

Hansen, Aleksander L. ; Andersen, Mette K. ; Engelhard, Leonie M. LU ; Brøns, Charlotte ; Hansen, Torben ; Nielsen, Jens S. ; Vestergaard, Peter ; Højlund, Kurt ; Jessen, Niels and Olsen, Michael H. , et al. (2025) In Diabetes, Obesity and Metabolism 27(4). p.2002-2011
Abstract

Aims: TCF7L2 rs7903146 is the most impactful single genetic risk variant for type 2 diabetes. However, its role on disease progression, complications and mortality among people with type 2 diabetes at diagnosis remains unclear. Materials and Methods: We assessed the per allele impact of the rs7903146 T-allele on clinical characteristics and complication risk in 9231 individuals with type 2 diabetes at diagnosis and over a 10-year follow-up period. Log-binomial and robust Poisson regression analyses were used to estimate prevalence ratios for clinical characteristics and macro- and microvascular complications at diabetes onset, while Cox regression was applied to estimate the risk of complications post-diagnosis. Analyses were adjusted... (More)

Aims: TCF7L2 rs7903146 is the most impactful single genetic risk variant for type 2 diabetes. However, its role on disease progression, complications and mortality among people with type 2 diabetes at diagnosis remains unclear. Materials and Methods: We assessed the per allele impact of the rs7903146 T-allele on clinical characteristics and complication risk in 9231 individuals with type 2 diabetes at diagnosis and over a 10-year follow-up period. Log-binomial and robust Poisson regression analyses were used to estimate prevalence ratios for clinical characteristics and macro- and microvascular complications at diabetes onset, while Cox regression was applied to estimate the risk of complications post-diagnosis. Analyses were adjusted for sex, calendar year at birth, age at enrollment and diabetes duration. Results: The per T-allele impact was associated with 0.6 kg/m2 (95% CI: 0.4, 0.8) lower BMI, 1.4 cm (95% CI: 1.0, 1.8) smaller waist circumference, 5.6% (95% CI: 4.2, 7.0) lower insulin secretion and 5.0% (95% CI: 3.3, 6.7) higher insulin sensitivity. Over 10 years, the per T-allele impact was associated with lower risks for major adverse cardiovascular events (0.87 [95% CI 0.79, 0.95]), myocardial infarction (0.82 [95% CI: 0.72, 0.93]) and heart failure (0.85 [95% CI 0.73, 1.00]), with no significant impact on microvascular complications. Conclusions: The TCF7L2 variant is associated with less obesity, lower insulin secretion and higher insulin action at diabetes onset, and decreased risk of cardiovascular events following type 2 diabetes onset.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiovascular disease, cohort study, diabetes complications, genetic predisposition, observational study, type 2 diabetes
in
Diabetes, Obesity and Metabolism
volume
27
issue
4
pages
10 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:39780311
  • scopus:85214662083
ISSN
1462-8902
DOI
10.1111/dom.16193
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
id
bb3d44df-adb1-494a-97d1-c146e5517b27
date added to LUP
2025-03-27 12:39:57
date last changed
2025-07-03 19:37:16
@article{bb3d44df-adb1-494a-97d1-c146e5517b27,
  abstract     = {{<p>Aims: TCF7L2 rs7903146 is the most impactful single genetic risk variant for type 2 diabetes. However, its role on disease progression, complications and mortality among people with type 2 diabetes at diagnosis remains unclear. Materials and Methods: We assessed the per allele impact of the rs7903146 T-allele on clinical characteristics and complication risk in 9231 individuals with type 2 diabetes at diagnosis and over a 10-year follow-up period. Log-binomial and robust Poisson regression analyses were used to estimate prevalence ratios for clinical characteristics and macro- and microvascular complications at diabetes onset, while Cox regression was applied to estimate the risk of complications post-diagnosis. Analyses were adjusted for sex, calendar year at birth, age at enrollment and diabetes duration. Results: The per T-allele impact was associated with 0.6 kg/m<sup>2</sup> (95% CI: 0.4, 0.8) lower BMI, 1.4 cm (95% CI: 1.0, 1.8) smaller waist circumference, 5.6% (95% CI: 4.2, 7.0) lower insulin secretion and 5.0% (95% CI: 3.3, 6.7) higher insulin sensitivity. Over 10 years, the per T-allele impact was associated with lower risks for major adverse cardiovascular events (0.87 [95% CI 0.79, 0.95]), myocardial infarction (0.82 [95% CI: 0.72, 0.93]) and heart failure (0.85 [95% CI 0.73, 1.00]), with no significant impact on microvascular complications. Conclusions: The TCF7L2 variant is associated with less obesity, lower insulin secretion and higher insulin action at diabetes onset, and decreased risk of cardiovascular events following type 2 diabetes onset.</p>}},
  author       = {{Hansen, Aleksander L. and Andersen, Mette K. and Engelhard, Leonie M. and Brøns, Charlotte and Hansen, Torben and Nielsen, Jens S. and Vestergaard, Peter and Højlund, Kurt and Jessen, Niels and Olsen, Michael H. and Thomsen, Reimar W. and Vaag, Allan}},
  issn         = {{1462-8902}},
  keywords     = {{cardiovascular disease; cohort study; diabetes complications; genetic predisposition; observational study; type 2 diabetes}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{2002--2011}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Diabetes, Obesity and Metabolism}},
  title        = {{Impact of TCF7L2 rs7903146 on clinical presentation and risk of complications in patients with type 2 diabetes}},
  url          = {{http://dx.doi.org/10.1111/dom.16193}},
  doi          = {{10.1111/dom.16193}},
  volume       = {{27}},
  year         = {{2025}},
}