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The Common –866G>A Variant in the Promoter of UCP2 Is Associated With Decreased Risk of Coronary Artery Disease in Type 2 Diabetic Men

¹ Institut National de la Santé et de la Recherche Médicale, Research Unit 695, Paris, France
² Department of Immunology and Diabetology, AP-HP Cochin Hospital, Paris, France
³ Laboratory of Cellular and Molecular Endocrinology, São Paulo University, São Paulo, Brazil
⁴ Laboratory of Molecular Endocrinology, Federal University of São Paulo, São Paulo, Brazil
⁵ Post-Graduation Program in Medical Sciences, Federal Faculty Foundation of Medical Sciences of Porto Alegre, Porto Alegre, Brazil
⁶ Department of Cardiology, Assistance Publique–Hôpitaux de Paris, La Pitié Hospital, Paris, France
⁷ Université Denis Diderot Paris 7, Paris, France
⁸ Université René Descartes Paris 5, Paris, France

Address correspondence and reprint requests to Dr. Gilberto Velho, Institut National de la Santé et de la Recherche Médicale U-695, Faculté de Médecine Xavier Bichat, 16 rue Henri Huchard, 75018 Paris, France. E-mail: velho{at}bichat.inserm.fr

Abbreviations: CABG, coronary artery bypass graft; CAD, coronary artery disease; DIABHYCAR Study, Non-Insulin-Dependent Diabetes, Hypertension, Microalbuminuria, Cardiovascular Events, and Ramipril Study; NCH, Necker and Cochin Hospitals; ROS, reactive oxygen species; SNP, single nucleotide polymorphism; UAC, urinary albumin concentration; UCP2, uncoupling protein 2

OBJECTIVE—Uncoupling protein 2 (UCP2) is a physiological downregulator of reactive oxygen species generation and plays an antiatherogenic role in the vascular wall. A common variant in the UCP2 promoter (–866G>A) modulates mRNA expression, with increased expression associated with the A allele. We investigated association of this variant with coronary artery disease (CAD) in two cohorts of type 2 diabetic subjects.

RESEARCH DESIGN AND METHODS—We studied 3,122 subjects from the 6-year prospective Non–Insulin-Dependent Diabetes, Hypertension, Microalbuminuria, Cardiovascular Events, and Ramipril (DIABHYCAR) Study (14.9% of CAD incidence at follow-up). An independent, hospital-based cohort of 335 men, 52% of whom had CAD, was also studied.

RESULTS—We observed an inverse association of the A allele with incident cases of CAD in a dominant model (hazard risk 0.88 [95% CI 0.80–0.96]; P = 0.006). Similar results were observed for baseline cases of CAD. Stratification by sex confirmed an allelic association with CAD in men, whereas no association was observed in women. All CAD phenotypes considered—myocardial infarction, angina pectoris, coronary artery bypass graft (CABG), and sudden death—contributed significantly to the association. Results were replicated in a cross-sectional study of an independent cohort (odds ratio 0.47 [95% CI 0.25–0.89]; P = 0.02 for a recessive model).

CONCLUSIONS—The A allele of the –866G>A variant of UCP2 was associated with reduced risk of CAD in men with type 2 diabetes in a 6-year prospective study. Decreased risk of myocardial infarction, angina pectoris, CABG, and sudden death contributed individually and significantly to the reduction of CAD risk. This association was independent of other common CAD risk factors.

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