Effects of TCF7L2 rs7903146 variant on metformin response in patients with type 2 diabetes

Tanja Dujic; Tamer Bego; Maja Malenica; Zelija Velija-Asimi; Emma Ahlqvist; Leif Groop; Ewan R. Pearson; Adlija Causevic; Sabina Semiz

doi:10.17305/bjbms.2019.4181

Authors

Tanja Dujic Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0001-9221-1208
Tamer Bego Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0002-6424-6945
Maja Malenica Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Zelija Velija-Asimi Department of Internal Medicine, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0003-2014-248X
Emma Ahlqvist Lund University Diabetes Centre, Lund University, Malmö, Sweden https://orcid.org/0000-0002-6513-2384
Leif Groop Lund University Diabetes Centre, Lund University, Malmö, Sweden
Ewan R. Pearson Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, Scotland, UK
Adlija Causevic Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0002-2203-0871
Sabina Semiz Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina; Faculty of Engineering and Natural Sciences, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina https://orcid.org/0000-0003-2629-4660

DOI:

https://doi.org/10.17305/bjbms.2019.4181

Keywords:

Metformin, type 2 diabetes, pharmacogenetics, transcription factor 7-like 2 gene, TCF7L2

Abstract

The response to metformin, the most commonly used drug for the treatment of type 2 diabetes (T2D), is highly variable. The common variant rs7903146 C>T within the transcription factor 7-like 2 gene (TCF7L2) is the strongest genetic risk factor associated with T2D to date. In this study, we explored the effects of the TCF7L2 rs7903146 genotype on metformin response in T2D. The study included 86 newly diagnosed patients with T2D, incident users of metformin. Levels of fasting glucose, insulin, HbA_1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and anthropometric parameters were measured prior to metformin therapy, and 6 and 12 months after the treatment. Genotyping of the TCF7L2 rs7903146 was performed by the Sequenom MassARRAY^® iPLEX^® platform. At baseline, the diabetes risk allele (T) showed an association with lower triglyceride levels (p = 0.037). After 12 months of metformin treatment, the T allele was associated with 25.9% lower fasting insulin levels (95% CI 10.9–38.3%, p = 0.002) and 29.1% lower HOMA-IR index (95% CI 10.1–44.1%, p = 0.005), after adjustment for baseline values. Moreover, the T allele was associated with 6.7% lower fasting glucose levels (95% CI 1.1–12.0%, p = 0.021), adjusted for baseline glucose and baseline HOMA-%B levels, after 6 months of metformin treatment. This effect was more pronounced in the TT carriers who had 16.8% lower fasting glucose levels (95% CI 7.0–25.6%, p = 0.002) compared to the patients with CC genotype. Our results suggest that the TCF7L2 rs7903146 variant affects markers of insulin resistance and glycemic response to metformin in newly diagnosed patients with T2D within the first year of metformin treatment.