Endothelial nitric oxide synthase (eNOS) gene represents a promising candidate gene for coronary heart disease (CHD) because of its impact on eNOS activity. We systematically examined the associations of eight variants of the eNOS gene (two potentially functional variants [؊786T>C and Glu298Asp] and six tagging single nucleotide polymorphisms) with CHD risk in a large cohort of diabetic patients. Among 861 diabetic men (>97% Caucasian) from the Health Professionals Follow-Up Study, 220 developed CHD, and 641 men without cardiovascular disease were used as control subjects. Genotype distributions of ؊786T>C and Glu298Asp polymorphisms were not significantly different between case and control subjects. CHD risk was significantly higher among men with the variant allele at the rs1541861 locus (intron 8 A/C) than men without it (adjusted odds ratio 1.5 [95% confidence interval 1.1-2.1]). Moreover, among control subjects, plasma soluble vascular cell adhesion molecule concentrations were significantly higher among carriers of this allele (P 0.019) and carriers of the variant allele of the ؊786T>C (P 0.010), or the Glu298Asp polymorphism (P 0.002), compared with noncarriers. In conclusion, our data suggested that ؊786T>C, Glu298Asp, and an intron 8 polymorphism of the eNOS gene are potentially involved in the atherogenic pathway among U.S. diabetic men. (1), and inhibiting the proliferation of smooth muscle cells (2). Endothelial-derived NO is synthesized from L-arginine by NO synthase encoded by endothelial NO synthase (eNOS or NOS3) gene, mapped on chromosome 7q36 (3). The eNOS gene knockout mouse was demonstrated to have an increased susceptibility to develop atherosclerosis independent of blood pressure changes (4). Both ex vivo and in vivo eNOS gene transfer to atherosclerotic arteries can improve acetycholine-induced endothelium-dependent vasodilation (5-10).The association between several polymorphisms of the eNOS gene and coronary heart disease (CHD) risk has been studied recently. In particular, the Ϫ786TϾC polymorphism in the 5Ј-flanking region and the Glu298Asp polymorphism in exon 7 have received the most attention; these two polymorphisms have been associated with alterations in eNOS activity in experimental studies (11)(12)(13)(14) and with the existence, severity, and progression of CHD in some, although not all, epidemiological studies (12,(15)(16)(17). The association of these potentially functional polymorphisms with CHD risk has not been well studied among diabetic patients. Furthermore, we are unaware of studies that have systematically investigated the association of variants of the eNOS gene with CHD risk. In the present study, we examined associations of the two potentially functional single nucleotide polymorphisms (SNPs) and tagging SNPs of the eNOS gene with CHD risk among diabetic men. The associations of these eNOS SNPs with circulating levels of soluble VCAM-1 (sVCAM-1) and ICAM-1 were also examined.
RESEARCH DESIGN AND METHODSThe Health Professionals Follow-Up Study is a prospective coho...