BackgroundDiabetes mellitus is the most common chronic endocrine disorder, affecting an estimated population of 382 million people worldwide. It is associated with microvascular and macrovascular complications, including diabetic nephropathy (DN); primary cause of end-stage renal disease. Different inflammatory and angiogenic molecules in various pathways are important modulators in the pathogenesis and progression of diabetic nephropathy. Differential disease risk in DN may be partly attributable to genetic susceptibility. In this meta-analysis, we aimed to determine which of the previously investigated genetic variants in these pathways are significantly associated with the development of DN and to examine the functional role of these genes.MethodsA systematic search was conducted to collect and analyze all studies published till June 2013; that investigated the association between genetic variants involved in inflammatory cytokines and angiogenesis and diabetic nephropathy. Genetic variants associated with DN were selected and analyzed by using Comprehensive Meta Analysis software. Pathway analysis of the genes with variants showing significant positive association with DN was performed using Genomatix Genome Analyzer (Genomatix, Munich, Germany).ResultsAfter the inclusion and exclusion criteria for this analysis, 34 studies were included in this meta-analysis. 11 genetic variants showed significant positive association with DN in a random-effects meta-analysis. These included genetic variants within or near VEGFA, CCR5, CCL2, IL-1, MMP9, EPO, IL-8, ADIPOQ and IL-10. rs1800871 (T) genetic variant in IL-10 showed protective effect for DN. Most of these eleven genetic variants were involved in GPCR signaling and receptor binding pathways whereas four were involved in chronic kidney failure. rs833061 [OR 2.08 (95% CI 1.63-2.66)] in the VEGFA gene and rs3917887 [OR 2.04 (95% CI 1.64-2.54)] in the CCL2 gene showed the most significant association with the risk of diabetic nephropathy.ConclusionsOur results indicate that 11 genetic variants within or near VEGFA, CCR5, CCL2, IL-1, MMP9, EPO, IL-8, ADIPOQ and IL-10 showed significant positive association with diabetic nephropathy. Gene Ontology or pathway analysis showed that these genes may contribute to the pathophysiology of DN. The functional relevance of the variants and their pathways can lead to increased biological insights and development of new therapeutic targets.Electronic supplementary materialThe online version of this article (doi:10.1186/s12881-014-0103-8) contains supplementary material, which is available to authorized users.
Introduction:
Hypertriglyceridemia (HTG) is one of the most common metabolic disorders
leading to pancreatitis and cardiovascular disease. HTG develops mostly due to impaired metabolism of
triglyceride-rich lipoproteins. Although monogenic types of HTG exist, most reported cases are polygenic
in nature.
Aim:
This review article is focused on the classification of Primary HTG and the genetic factors behind
its development with the aim of providing clinicians a useful tool for early detection of the disease in
order to administer proper and effective treatment.
Discussion:
HTG is often characterized by a complex phenotype resulting from interactions between
genetic and environmental factors. In many instances, the complexity, perplexing causes, and classification
of HTG make it difficult for clinicians to properly diagnose and manage the disorder. Better
availability of information on its pathophysiology, genetic factors involved, environmental causes, and
their interactions could help in understanding such complex disorders and could support its effective
diagnosis and treatment.
Conclusion:
The current review has summarized the case definition, epidemiology, pathophysiology,
clinical presentation, classification, associated genetic factors, and scope of genetic screening in the diagnosis
of primary HTG.
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