OBJECTIVE-Variants in the ectonucleotide pyrophosphatase/ phosphodiesterase 1 (ENPP1) gene have shown positive associations with diabetes and related phenotypes, including insulin resistance, metabolic syndrome, and type 1 diabetic nephropathy. Additionally, evidence for linkage for type 2 diabetes in African Americans was observed at 6q24-27, with the proximal edge of the peak encompassing the ENPP1 gene. Our objective was to comprehensively evaluate variants in ENPP1 for association with type 2 diabetic end-stage renal disease (ESRD).RESEARCH DESIGN AND METHODS-Forty-nine single nucleotide polymorphisms (SNPs) located in the coding and flanking regions of ENPP1 were genotyped in 577 African-American individuals with type 2 diabetic ESRD and 596 African-American control subjects. Haplotypic association and genotypic association for the dominant, additive, and recessive models were tested by calculating a 2 statistic and corresponding P value.
RESULTS-NineSNPs showed nominal evidence for association (P Ͻ 0.05) with type 2 diabetic ESRD in one or more genotypic model. The most significant associations were observed with rs7754586 (P ϭ 0.003 dominant model, P ϭ 0.0005 additive, and P ϭ 0.007 recessive), located in the 3Ј untranslated region, and an intron 24 SNP (rs1974201: P ϭ 0.004 dominant, P ϭ 0.0005 additive, and P ϭ 0.005 recessive). However, the extensively studied K121Q variant (rs1044498) did not reveal evidence for association with type 2 diabetic ESRD in this African-American population. T he ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) gene, also referred to as plasma cell membrane glycoprotein (PC-1), spans over 83 kb and is located on chromosome 6q22-23. ENPP1 was first described as a mediator of insulin resistance by Goldfine et al. (1), and the K121Q variant was subsequently determined to be associated with insulin resistance in humans using euglycemic clamp studies (2). Variants in ENPP1, primarily K121Q, have shown positive associations with obesity and BMI (3-5), metabolic syndrome (6), and type 2 diabetes (3,7,8). Negative association results for these variants in large meta-analyses of Caucasian populations (9 -11) question the reproducibility of these positive findings, although a recent meta-analysis of Ͼ40,000 Caucasian individuals from 30 studies detected a modest association with 121Q under a recessive model (12).
CONCLUSIONS-ThisThree previous association studies of the ENPP1 gene in populations of African descent, two in African Americans (5,13) and one in Afro-Caribbeans from the Dominican Republic (14), have focused exclusively on associations with the K121Q variant. These studies found a much higher frequency of the 121Q allele (74 -78% in African Americans and 54.2% Dominicans) than that observed in other populations, and two of the three studies found an association with type 2 diabetes (13,14) but the third did not (5). These equivocal results suggest that further examination of variants in the ENPP1 gene in additional populations with African ancestry is warranted.A...