Aims/hypothesis The transcription factor 7-like 2 (TCF7L2) rs7903146 T allele associates with type 2 diabetes in several populations, possibly mediated via decreased incretin secretion and/or action and altered beta and alpha cell function. We aimed to study circulating levels of glucose, proinsulin, insulin, C-peptide, glucagon, glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2) and gastric inhibitory polypeptide (GIP) among individuals carrying the high-risk rs7903146 TT genotype and lowrisk CC genotype following a meal test. Methods A meal challenge was performed in 31 glucosetolerant men (age 54±7 years and BMI 26±3 kg/m 2 ) with rs7903146 TT genotype and 31 glucose-tolerant age-and BMI-matched men with CC genotype (age 53±6 years and BMI 26±3 kg/m 2 ). Serum proinsulin, insulin, C-peptide and plasma glucose, glucagon, GLP-1, GLP-2 and GIP were obtained 0,15,30,45, 60, 75, 90, 105, 120, 135, 150, 180, 210, and 240 min after ingestion of a standardised breakfast meal. Results An elevated incremental AUC for plasma glucose was observed among TT genotype carriers (CC carriers 21.8±101.9 mmol/l×min vs TT carriers 97.9±89.2 mmol/ l×min, p=0.001). TT carriers also had increased AUCs for proinsulin (CC carriers 6,030±3,001 pmol/l×min vs TT carriers 6,917±4,820 pmol/l×min, p=0.03), C-peptide (CC carriers 397.6±131.9 nmol/l×min vs TT carriers 417.1± 109.3 nmol/l×min, p=0.04) and GIP (CC carriers 12,310± 3,840 pmol/l×min vs TT carriers 14,590±5,910 pmol/l× min, p=0.004).A. P. Gjesing and L.L. Kjems contributed equally to this study. Diabetologia (2011) 54:103-110 DOI 10.1007/s00125-010-1940 Conclusions/interpretation Middle-aged normoglycaemic individuals carrying the rs7903146 TCF7L2 risk TT genotype show early signs of dysregulated glucose metabolism, decreased processing of proinsulin and elevated GIP secretion following a meal challenge.
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