Transporters, TBC1D4, and ARID5B Variants to Explain Glycated Hemoglobin Variability in Patients with Type 2 Diabetes

Pharmacology. 2021;106(11-12):588-596. doi: 10.1159/000517462. Epub 2021 Jul 15.

Abstract

Introduction: Genetic variants could aid in predicting antidiabetic drug response by associating them with markers of glucose control, such as glycated hemoglobin (HbA1c). However, pharmacogenetic implementation for antidiabetics is still under development, as the list of actionable markers is being populated and validated. This study explores potential associations between genetic variants and plasma levels of HbA1c in 100 patients under treatment with metformin.

Methods: HbA1c was measured in a clinical chemistry analyzer (Roche), genotyping was performed in an Illumina-GSA array and data were analyzed using PLINK. Association and prediction models were developed using R and a 10-fold cross-validation approach.

Results: We identified genetic variants on SLC47A1, SLC28A1, ABCG2, TBC1D4, and ARID5B that can explain up to 55% of the interindividual variability of HbA1c plasma levels in diabetic patients under treatment. Variants on SLC47A1, SLC28A1, and ABCG2 likely impact the pharmacokinetics (PK) of metformin, while the role of the two latter can be related to insulin resistance and regulation of adipogenesis.

Conclusions: Our results confirm previous genetic associations and point to previously unassociated gene variants for metformin PK and glucose control.

Keywords: Glycated hemoglobin; Metformin; Pharmacogenomics; Pharmacokinetics; Type 2 diabetes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • Body Mass Index
  • DNA-Binding Proteins / genetics*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • GTPase-Activating Proteins / genetics*
  • Genotype
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / genetics*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Metformin / therapeutic use*
  • Middle Aged
  • Organic Cation Transport Proteins / genetics
  • Transcription Factors / genetics*

Substances

  • ARID5B protein, human
  • DNA-Binding Proteins
  • GTPase-Activating Proteins
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Organic Cation Transport Proteins
  • TBC1D4 protein, human
  • Transcription Factors
  • Metformin