G/T Substitution in Intron 1 of the UNC13B Gene Is Associated With Increased Risk of Nephropathy in Patients With Type 1 Diabetes

  1. David-Alexandre Trégouet1,
  2. Per-Henrik Groop23,
  3. Steven McGinn4,
  4. Carol Forsblom23,
  5. Samy Hadjadj56,
  6. Michel Marre78,
  7. Hans-Henrik Parving9,
  8. Lise Tarnow10,
  9. Ralph Telgmann11,
  10. Tiphaine Godefroy1,
  11. Viviane Nicaud1,
  12. Rachel Rousseau1,
  13. Maikki Parkkonen3,
  14. Anna Hoverfält3,
  15. Ivo Gut4,
  16. Simon Heath4,
  17. Fumihiko Matsuda4,
  18. Roger Cox12,
  19. Gbenga Kazeem13,
  20. Martin Farrall13,
  21. Dominique Gauguier13,
  22. Stefan-Martin Brand-Herrmann11,
  23. François Cambien1,
  24. Mark Lathrop4,
  25. Nathalie Vionnet1 and
  26. for the EURAGEDIC Consortium
  1. 1INSERM, Paris, France, and Pierre and Marie Curie-Paris VI University, Paris, France
  2. 2Helsinki University Central Hospital, Department of Medicine, Division of Nephrology, Helsinki, Finland
  3. 3Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum, Helsinki, Finland
  4. 4CEA/Institute of Genomics-National Genotyping Center, Evry, France
  5. 5CHU Poitiers, Department of Diabetology, Poitiers, France
  6. 6INSERM U927, CHU Poitiers, Poitiers, France
  7. 7Assistance Publique des Hôpitaux de Paris, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
  8. 8Université Paris, INSERM U695, Paris, France
  9. 9University Hospital of Copenhagen, Rigshospitalet, Department of Medical Endocrinology, Copenhagen, Denmark
  10. 10Steno Diabetes Center, Copenhagen, Denmark
  11. 11Leibniz Institute for Arteriosclerosis Research, Department of Molecular Genetics of Cardiovascular Disease, University of Muenster, Muenster, Germany
  12. 12Mammalian Research Council, Mammalian Genetics Unit, Harwell, U.K
  13. 13Wellcome Trust Center for Human Genetics, University of Oxford, Oxford, U.K
  1. Corresponding author: Nathalie Vionnet, vionnet{at}cng.fr


OBJECTIVE— Genetic and environmental factors modulate the susceptibility to diabetic nephropathy, as initiating and/or progression factors. The objective of the European Rational Approach for the Genetics of Diabetic Complications (EURAGEDIC) study is to identify nephropathy susceptibility genes. We report molecular genetic studies for 127 candidate genes for nephropathy.

RESEARCH DESIGN AND METHODS— Polymorphisms were identified through sequencing of promoter, exon, and flanking intron gene regions and a database search. A total of 344 nonredundant SNPs and nonsynonymous variants were tested for association with diabetic nephropathy (persistent albuminuria ≥300 mg/24 h) in a large type 1 diabetes case/control (1,176/1,323) study from three European populations.

RESULTS— Only one SNP, rs2281999, located in the UNC13B gene, was significantly associated with nephropathy after correction for multiple testing. Analyses of 21 additional markers fully characterizing the haplotypic variability of the UNC13B gene showed consistent association of SNP rs13293564 (G/T) located in intron 1 of the gene with nephropathy in the three populations. The odds ratio (OR) for nephropathy associated with the TT genotype was 1.68 (95% CI 1.29–2.19) (P = 1.0 × 10−4). This association was replicated in an independent population of 412 case subjects and 614 control subjects (combined OR of 1.63 [95% CI 1.30–2.05], P = 2.3 × 10−5).

CONCLUSIONS— We identified a polymorphism in the UNC13B gene associated with nephropathy. UNC13B mediates apopotosis in glomerular cells in the presence of hyperglycemia, an event occurring early in the development of nephropathy. We propose that this polymorphism could be a marker for the initiation of nephropathy. However, further studies are needed to clarify the role of UNC13B in nephropathy.


  • Published ahead of print at http://diabetes.diabetesjournals.org on 15 July 2008.

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    • Accepted July 8, 2008.
    • Received January 18, 2008.
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  1. Diabetes vol. 57 no. 10 2843-2850
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