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Gene Polymorphism and Nutrition: Relationships with Chronic Disease

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrigenetics and Nutrigenomics".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 34698

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Special Issue Editors

1. Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
2. Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
Interests: obesity; nutrigenetics; enteral nutrition; malnutrition related to the disease
Special Issues, Collections and Topics in MDPI journals
Director of Epigenomics in Endocrinology and Nutrition Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
Interests: epigenomics; nutriepigenomics; mitoepigenetics; DNA methylation; epigenetic clock; nutrition; atlantic diet; ketogenic diet; ketone bodies; bioactive compounds; vitamins; antioxidants; cancer; obesity; oxidative stress; inflammation; adipokines; myokines; hepatokines; body composition; metabolism; biomarkers; liquid biopsia; adipose tissue; liver; muscle; blood leukocytes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Studies of global human genomic variation have shown important population-based differences in allele frequencies of common single nucleotide polymorphisms (SNPs) that influence the expression of genes related with nutrition and, secondarily, with chronic disease. Some SNP sites have known functions or associations with diseases or other phenotype characteristics, including nutritional deficiencies and metabolism dietary components. There are many components of human diets that, when combined with the impact of diverse genetics on the metabolism of certain nutrients, have the capacity to give rise to harmful diet–gene interactions. This situation has the potential capacity to modify molecular phenotypes and clinical phenotypes, including human disease. Obesity, diabetes mellitus, chronobiology, osteoporosis, cancer, and many diseases are a field of potential investigation in this topic area. This Special Issue will include manuscripts that focus on the complex relationship between gene polymorphism and nutrition across all physiological and chronic diseases.

Dr. Daniel-Antonio de Luis Roman
Dr. Ana B. Crujeiras
Guest Editors

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Keywords

  • chronic disease
  • personalized nutrition
  • single nucleotide polymorphism

Published Papers (10 papers)

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Research

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10 pages, 900 KiB  
Article
Sex-Dependent Mediation of Leptin in the Association of Perilipin Polymorphisms with BMI and Plasma Lipid Levels in Children
by Claudia Vales-Villamarín, Jairo Lumpuy-Castillo, Teresa Gavela-Pérez, Olaya de Dios, Iris Pérez-Nadador, Leandro Soriano-Guillén and Carmen Garcés
Nutrients 2022, 14(15), 3072; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14153072 - 26 Jul 2022
Cited by 1 | Viewed by 1477
Abstract
Variations in the perilipin (PLIN) gene have been suggested to be associated with obesity and its related alterations, but a different nutritional status seems to contribute to differences in these associations. In our study, we examined the association of several polymorphisms [...] Read more.
Variations in the perilipin (PLIN) gene have been suggested to be associated with obesity and its related alterations, but a different nutritional status seems to contribute to differences in these associations. In our study, we examined the association of several polymorphisms at the PLIN locus with obesity and lipid profile in children, and then analyzed the mediation of plasma leptin levels on these associations. The single-nucleotide polymorphisms (SNPs) rs894160, rs1052700, and rs2304795 in PLIN1, and rs35568725 in PLIN2, were analyzed by RT-PCR in 1264 children aged 6–8 years. Our results showed a contrasting association of PLIN1 rs1052700 with apolipoprotein (Apo) A-I levels in boys and girls, with genotype TT carriers showing significantly higher Apo A-I levels in boys and significantly lower Apo A-I levels in girls. Significant associations of the SNP PLIN2 rs35568725 with high-density lipoprotein cholesterol (HDL-cholesterol), Apo A-I, and non-esterified fatty acids (NEFA) were observed in boys but not in girls. The associations of the SNPs studied with body mass index (BMI), NEFA, and Apo A-I in boys and girls were different depending on leptin concentration. In conclusion, we describe the mediation of plasma leptin levels in the association of SNPs in PLIN1 and PLIN2 with BMI, Apo A-I, and NEFA. Different leptin levels by sex may contribute to explain the sex-dependent association of the PLIN SNPs with these variables. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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12 pages, 1073 KiB  
Article
Genetic Variants in Folate and Cobalamin Metabolism-Related Genes in Pregnant Women of a Homogeneous Spanish Population: The Need for Revisiting the Current Vitamin Supplementation Strategies
by Gemma Rodriguez-Carnero, Paula M. Lorenzo, Ana Canton-Blanco, Leire Mendizabal, Maddi Arregi, Mirella Zulueta, Laureano Simon, Manuel Macia-Cortiñas, Felipe F. Casanueva and Ana B. Crujeiras
Nutrients 2022, 14(13), 2702; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14132702 - 29 Jun 2022
Cited by 1 | Viewed by 2647
Abstract
Polymorphisms of genes involved in the metabolism and transport of folate and cobalamin could play relevant roles in pregnancy outcomes. This study assessed the prevalence of genetic polymorphisms of folate and cobalamin metabolism-related genes such as MTHFR, MTR, CUBN, and SLC19A1 in pregnant [...] Read more.
Polymorphisms of genes involved in the metabolism and transport of folate and cobalamin could play relevant roles in pregnancy outcomes. This study assessed the prevalence of genetic polymorphisms of folate and cobalamin metabolism-related genes such as MTHFR, MTR, CUBN, and SLC19A1 in pregnant women of a homogeneous Spanish population according to conception, pregnancy, delivery, and newborns complications. This study was conducted on 149 nulliparous women with singleton pregnancies. Sociodemographic and obstetrics variables were recorded, and all patients were genotyped in the MTHFR, MTR, CUBN, and SLC10A1 polymorphisms. The distribution of genotypes detected in this cohort was similar to the population distribution reported in Europe, highlighting that more than 50% of women were carriers of risk alleles of the studied genes. In women with the MTHFR risk allele, there was a statistically significant higher frequency of assisted fertilisation and a higher frequency of preeclampsia and preterm birth. Moreover, CUBN (rs1801222) polymorphism carriers showed a statistically significantly lower frequency of complications during delivery. In conclusion, the prevalence of genetic variants related to folic acid and vitamin B12 metabolic genes in pregnant women is related to mother and neonatal outcomes. Knowing the prevalence of these polymorphisms may lead to a personalised prescription of vitamin intake. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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17 pages, 481 KiB  
Article
FTO and ADRB2 Genetic Polymorphisms Are Risk Factors for Earlier Excessive Gestational Weight Gain in Pregnant Women with Pregestational Diabetes Mellitus: Results of a Randomized Nutrigenetic Trial
by Karina dos Santos, Eliane Lopes Rosado, Ana Carolina Proença da Fonseca, Gabriella Pinto Belfort, Letícia Barbosa Gabriel da Silva, Marcelo Ribeiro-Alves, Verônica Marques Zembrzuski, J. Alfredo Martínez and Cláudia Saunders
Nutrients 2022, 14(5), 1050; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14051050 - 01 Mar 2022
Cited by 9 | Viewed by 3225
Abstract
Excessive gestational weight gain (GWG) is associated with increased risk of maternal and neonatal complications. We investigated obesity-related polymorphisms in the FTO gene (rs9939609, rs17817449) and ADRB2 (rs1042713, rs1042714) as candidate risk factors concerning excessive GWG in pregnant women with pregestational diabetes. This [...] Read more.
Excessive gestational weight gain (GWG) is associated with increased risk of maternal and neonatal complications. We investigated obesity-related polymorphisms in the FTO gene (rs9939609, rs17817449) and ADRB2 (rs1042713, rs1042714) as candidate risk factors concerning excessive GWG in pregnant women with pregestational diabetes. This nutrigenetic trial, conducted in Brazil, randomly assigned 70 pregnant women to one of the groups: traditional diet (n = 41) or DASH diet (n = 29). Excessive GWG was the total weight gain above the upper limit of the recommendation, according to the Institute of Medicine guidelines. Genotyping was performed using real-time PCR. Time-to-event analysis was performed to investigate risk factors for progression to excessive GWG. Regardless the type of diet, AT carriers of rs9939609 (FTO) and AA carriers of rs1042713 (ADRB2) had higher risk of earlier exceeding GWG compared to TT (aHR 2.44; CI 95% 1.03–5.78; p = 0.04) and GG (aHR 3.91; CI 95% 1.12–13.70; p = 0.03) genotypes, respectively, as the AG carriers for FTO haplotype rs9939609:rs17817449 compared to TT carriers (aHR 1.79; CI 95% 1.04–3.06; p = 0.02). Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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19 pages, 1704 KiB  
Article
Effects of Dietary Fat to Carbohydrate Ratio on Obesity Risk Depending on Genotypes of Circadian Genes
by Jinyoung Shon, Yerim Han and Yoon Jung Park
Nutrients 2022, 14(3), 478; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14030478 - 22 Jan 2022
Cited by 6 | Viewed by 3618
Abstract
Although the impacts of macronutrients and the circadian clock on obesity have been reported, the interactions between macronutrient distribution and circadian genes are unclear. The aim of this study was to explore macronutrient intake patterns in the Korean population and associations between the [...] Read more.
Although the impacts of macronutrients and the circadian clock on obesity have been reported, the interactions between macronutrient distribution and circadian genes are unclear. The aim of this study was to explore macronutrient intake patterns in the Korean population and associations between the patterns and circadian gene variants and obesity. After applying the criteria, 5343 subjects (51.6% male, mean age 49.4 ± 7.3 years) from the Korean Genome and Epidemiology Study data and nine variants in seven circadian genes were analyzed. We defined macronutrient intake patterns by tertiles of the fat to carbohydrate ratio (FC). The very low FC (VLFC) was associated with a higher risk of obesity than the optimal FC (OFC). After stratification by the genotypes of nine variants, the obesity risk according to the patterns differed by the variants. In the female VLFC, the major homozygous allele of CLOCK rs11932595 and CRY1 rs3741892 had a higher abdominal obesity risk than those in the OFC. The GG genotype of PER2 rs2304672 in the VLFC showed greater risks for obesity and abdominal obesity. In conclusion, these findings suggest that macronutrient intake patterns were associated with obesity susceptibility, and the associations were different depending on the circadian clock genotypes of the CLOCK, PER2, and CRY1 loci. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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9 pages, 1977 KiB  
Article
Vitamin D Receptor (VDR) Gene Polymorphisms Modify the Response to Vitamin D Supplementation: A Systematic Review and Meta-Analysis
by Ricardo Usategui-Martín, Daniel-Antonio De Luis-Román, José María Fernández-Gómez, Marta Ruiz-Mambrilla and José-Luis Pérez-Castrillón
Nutrients 2022, 14(2), 360; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14020360 - 15 Jan 2022
Cited by 38 | Viewed by 5224
Abstract
The vitamin D receptor (VDR), a member of the nuclear receptor superfamily of transcriptional regulators, is crucial to calcitriol signalling. VDR is regulated by genetic and environmental factors and it is hypothesised that the response to vitamin D supplementation could be modulated by [...] Read more.
The vitamin D receptor (VDR), a member of the nuclear receptor superfamily of transcriptional regulators, is crucial to calcitriol signalling. VDR is regulated by genetic and environmental factors and it is hypothesised that the response to vitamin D supplementation could be modulated by genetic variants in the VDR gene. The best studied polymorphisms in the VDR gene are Apal (rs7975232), BsmI (rs1544410), Taql (rs731236) and Fokl (rs10735810). We conducted a systematic review and meta-analysis to evaluate the response to vitamin D supplementation according to the BsmI, TaqI, ApaI and FokI polymorphisms. We included studies that analysed the relationship between the response to vitamin D supplementation and the genotypic distribution of these polymorphisms. We included eight studies that enrolled 1038 subjects. The results showed no significant association with the BsmI and ApaI polymorphisms (p = 0.081 and p = 0.63) and that the variant allele (Tt+tt) of the TaqI polymorphism and the FF genotype of the FokI variant were associated with a better response to vitamin D supplementation (p = 0.02 and p < 0.001). In conclusion, the TaqI and FokI polymorphisms could play a role in the modulation of the response to vitamin D supplementation, as they are associated with a better response to supplementation. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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15 pages, 2182 KiB  
Article
Vitamin D and the Risks of Depression and Anxiety: An Observational Analysis and Genome-Wide Environment Interaction Study
by Zhen Zhang, Xuena Yang, Yumeng Jia, Yan Wen, Shiqiang Cheng, Peilin Meng, Chun’e Li, Huijie Zhang, Chuyu Pan, Jingxi Zhang, Yujing Chen and Feng Zhang
Nutrients 2021, 13(10), 3343; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103343 - 24 Sep 2021
Cited by 10 | Viewed by 5209
Abstract
Previous studies have suggested that vitamin D (VD) was associated with psychiatric diseases, but efforts to elucidate the functional relevance of VD with depression and anxiety from genetic perspective have been limited. Based on the UK Biobank cohort, we first calculated polygenic risk [...] Read more.
Previous studies have suggested that vitamin D (VD) was associated with psychiatric diseases, but efforts to elucidate the functional relevance of VD with depression and anxiety from genetic perspective have been limited. Based on the UK Biobank cohort, we first calculated polygenic risk score (PRS) for VD from genome-wide association study (GWAS) data of VD. Linear and logistic regression analysis were conducted to evaluate the associations of VD traits with depression and anxiety traits, respectively. Then, using individual genotype and phenotype data from the UK Biobank, genome-wide environment interaction studies (GWEIS) were performed to identify the potential effects of gene × VD interactions on the risks of depression and anxiety traits. In the UK Biobank cohort, we observed significant associations of blood VD level with depression and anxiety traits, as well as significant associations of VD PRS and depression and anxiety traits. GWEIS identified multiple candidate loci, such as rs114086183 (p = 4.11 × 10−8, LRRTM4) for self-reported depression status and rs149760119 (p = 3.88 × 10−8, GNB5) for self-reported anxiety status. Our study results suggested that VD was negatively associated with depression and anxiety. GWEIS identified multiple candidate genes interacting with VD, providing novel clues for understanding the biological mechanism potential associations between VD and psychiatric disorders. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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14 pages, 1137 KiB  
Article
Association Study among Comethylation Modules, Genetic Polymorphisms and Clinical Features in Mexican Teenagers with Eating Disorders: Preliminary Results
by Germán Alberto Nolasco-Rosales, José Jaime Martínez-Magaña, Isela Esther Juárez-Rojop, Thelma Beatriz González-Castro, Carlos Alfonso Tovilla-Zarate, Ana Rosa García, Emmanuel Sarmiento, David Ruiz-Ramos, Alma Delia Genis-Mendoza and Humberto Nicolini
Nutrients 2021, 13(9), 3210; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093210 - 15 Sep 2021
Cited by 1 | Viewed by 2396
Abstract
Eating disorders are psychiatric disorders characterized by disturbed eating behaviors. They have a complex etiology in which genetic and environmental factors interact. Analyzing gene-environment interactions could help us to identify the mechanisms involved in the etiology of such conditions. For example, comethylation module [...] Read more.
Eating disorders are psychiatric disorders characterized by disturbed eating behaviors. They have a complex etiology in which genetic and environmental factors interact. Analyzing gene-environment interactions could help us to identify the mechanisms involved in the etiology of such conditions. For example, comethylation module analysis could detect the small effects of epigenetic interactions, reflecting the influence of environmental factors. We used MethylationEPIC and Psycharray microarrays to determine DNA methylation levels and genotype from 63 teenagers with eating disorders. We identified 11 comethylation modules in WGCNA (Weighted Gene Correlation Network Analysis) and correlated them with single nucleotide polymorphisms (SNP) and clinical features in our subjects. Two comethylation modules correlated with clinical features (BMI and height) in our sample and with SNPs associated with these phenotypes. One of these comethylation modules (yellow) correlated with BMI and rs10494217 polymorphism (associated with waist-hip ratio). Another module (black) was correlated with height, rs9349206, rs11761528, and rs17726787 SNPs; these polymorphisms were associated with height in previous GWAS. Our data suggest that genetic variations could alter epigenetics, and that these perturbations could be reflected as variations in clinical features. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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11 pages, 268 KiB  
Article
Adiponectin Gene Variant rs3774261, Effects on Lipid Profile and Adiponectin Levels after a High Polyunsaturated Fat Hypocaloric Diet with Mediterranean Pattern
by Daniel Antonio de Luis Roman, David Primo, Olatz IZaola, Emilia Gómez and Juan Jose López
Nutrients 2021, 13(6), 1811; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061811 - 26 May 2021
Cited by 4 | Viewed by 2129
Abstract
The role of ADIPOQ gene variants on metabolic improvements after weight change secondary to different hypocaloric diets remained unclear. We evaluate the effect of rs3774261 of ADIPOQ gene polymorphism on biochemical improvements and weight change after high polyunsaturated fat hypocaloric diet with a [...] Read more.
The role of ADIPOQ gene variants on metabolic improvements after weight change secondary to different hypocaloric diets remained unclear. We evaluate the effect of rs3774261 of ADIPOQ gene polymorphism on biochemical improvements and weight change after high polyunsaturated fat hypocaloric diet with a Mediterranean dietary pattern for 12 weeks. A population of 361 obese subjects was enrolled in an intervention trial with a calorie restriction of 500 calories over the usual intake and 45.7% of carbohydrates, 34.4% of fats, and 19.9% of proteins. The percentages of different fats was; 21.8% of monounsaturated fats, 55.5% of saturated fats, and 22.7% of polyunsaturated fats. Before and after intervention, an anthropometric study, an evaluation of nutritional intake and a biochemical evaluation were realized. All patients lost weight regardless of genotype and diet used. After 12 weeks with a similar improvement in weight loss (AA vs. AG vs. GG); total cholesterol (delta: −28.1 ± 2.1 mg/dL vs. −14.2 ± 4.1 mg/dL vs. −11.0 ± 3.9 mg/dL; p = 0.02), LDL cholesterol (delta: −17.1 ± 2.1 mg/dL vs. −6.1 ± 1.9 mg/dL vs. −6.0 ± 2.3 mg/dL; p = 0.01), triglyceride levels (delta: −35.0 ± 3.6 mg/dL vs. 10.1 ± 3.2 mg/dL vs. −9.7 ± 3.1 mg/dL; p = 0.02), C reactive protein (CRP) (delta: −2.3 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL; p = 0.02), serum adiponectin (delta: 11.6 ± 2.9 ng/dL vs. 2.1 ± 1.3 ng/dL vs. 3.3 ± 1.1 ng/dL; p = 0.02) and adiponectin/leptin ratio (delta: 1.5 ± 0.1 ng/dL vs. 0.3 ± 0.2 ng/dL vs. 0.4 ± 0.3 ng/dL; p = 0.03), improved only in AA group. AA genotype of ADIPOQ variant (rs3774261) is related with a significant increase in serum levels of adiponectin and ratio adiponectin/leptin and decrease on lipid profile and C-reactive protein (CRP). Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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Review

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15 pages, 573 KiB  
Review
Impact of Genetic Polymorphism on Response to Therapy in Non-Alcoholic Fatty Liver Disease
by José Ignacio Martínez-Montoro, Isabel Cornejo-Pareja, Ana María Gómez-Pérez and Francisco J. Tinahones
Nutrients 2021, 13(11), 4077; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114077 - 15 Nov 2021
Cited by 5 | Viewed by 2978
Abstract
In the last decades, the global prevalence of non-alcoholic fatty liver disease (NAFLD) has reached pandemic proportions with derived major health and socioeconomic consequences; this tendency is expected to be further aggravated in the coming years. Obesity, insulin resistance/type 2 diabetes mellitus, sedentary [...] Read more.
In the last decades, the global prevalence of non-alcoholic fatty liver disease (NAFLD) has reached pandemic proportions with derived major health and socioeconomic consequences; this tendency is expected to be further aggravated in the coming years. Obesity, insulin resistance/type 2 diabetes mellitus, sedentary lifestyle, increased caloric intake and genetic predisposition constitute the main risk factors associated with the development and progression of the disease. Importantly, the interaction between the inherited genetic background and some unhealthy dietary patterns has been postulated to have an essential role in the pathogenesis of NAFLD. Weight loss through lifestyle modifications is considered the cornerstone of the treatment for NAFLD and the inter-individual variability in the response to some dietary approaches may be conditioned by the presence of different single nucleotide polymorphisms. In this review, we summarize the current evidence on the influence of the association between genetic susceptibility and dietary habits in NAFLD pathophysiology, as well as the role of gene polymorphism in the response to lifestyle interventions and the potential interaction between nutritional genomics and other emerging therapies for NAFLD, such as bariatric surgery and several pharmacologic agents. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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Other

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15 pages, 941 KiB  
Systematic Review
Vitamin D and Type 1 Diabetes Risk: A Systematic Review and Meta-Analysis of Genetic Evidence
by Liana Najjar, Joshua Sutherland, Ang Zhou and Elina Hyppönen
Nutrients 2021, 13(12), 4260; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124260 - 26 Nov 2021
Cited by 10 | Viewed by 3491
Abstract
Several observational studies have examined vitamin D pathway polymorphisms and their association with type 1 diabetes (T1D) susceptibility, with inconclusive results. We aimed to perform a systematic review and meta-analysis assessing associations between selected variants affecting 25-hydroxyvitamin D [25(OH)D] and T1D risk. We [...] Read more.
Several observational studies have examined vitamin D pathway polymorphisms and their association with type 1 diabetes (T1D) susceptibility, with inconclusive results. We aimed to perform a systematic review and meta-analysis assessing associations between selected variants affecting 25-hydroxyvitamin D [25(OH)D] and T1D risk. We conducted a systematic search of Medline, Embase, Web of Science and OpenGWAS updated in April 2021. The following keywords “vitamin D” and/or “single nucleotide polymorphisms (SNPs)” and “T1D” were selected to identify relevant articles. Seven SNPs (or their proxies) in six genes were analysed: CYP2R1 rs10741657, CYP2R1 (low frequency) rs117913124, DHCR7/NADSYN1 rs12785878, GC rs3755967, CYP24A1 rs17216707, AMDHD1 rs10745742 and SEC23A rs8018720. Seven case-control and three cohort studies were eligible for quantitative synthesis (n = 10). Meta-analysis results suggested no association with T1D (range of pooled ORs for all SNPs: 0.97–1.02; p > 0.01). Heterogeneity was found in DHCR7/NADSYN1 rs12785878 (I2: 64.8%, p = 0.02). Sensitivity analysis showed exclusion of any single study did not alter the overall pooled effect. No association with T1D was observed among a Caucasian subgroup. In conclusion, the evidence from the meta-analysis indicates a null association between selected variants affecting serum 25(OH)D concentrations and T1D. Full article
(This article belongs to the Special Issue Gene Polymorphism and Nutrition: Relationships with Chronic Disease)
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