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The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus.

Abstract
The rs10830963 variant of the Melatonin Receptor 1B (MTNR1B) gene is associated with the development of gestational diabetes mellitus (GDM). We hypothesized that carrying the rs10830963/G risk allele had effect on antenatal insulin therapy (AIT) initiation in GDM in a body mass index (BMI)-dependent manner. Design: In this post hoc analysis the MTNR1B rs10830963 genotype and the clinical data of 211 Caucasian GDM patients were assessed. As a first step, a pre-pregnancy BMI threshold was determined where the effect of MTNR1B rs10830963/G allele carrying on AIT initiation was the most significant using logistic regression. Maternal age adjusted real-life odds ratios (OR) values were calculated. The chi-square test was also used to calculate the p value and 10.000 bootstrap simulations were performed in each case to re-assess the statistical power and the OR. Carrying the MTNR1B rs10830963/G allele increased the odds of AIT initiation (OR = 5.2, p = 0.02 [χ² test], statistical power = 0.53) in GDM patients with pre-pregnancy BMI ≥ 29 kg/m². The statistical power reached 0.77, when the pre-pregnancy BMI cutoff of 27 kg/m² was used and the genetic effect on AIT initiation was still significant, but only using the logistic regression model. Carrying the MTNR1B rs10830963/G risk allele-in interaction with pre-pregnancy BMI-is likely be considered as a candidate pharmacogenetic marker of antenatal insulin therapy initiation and should be further assessed in precision medicine trials in GDM.
AuthorsGábor Firneisz, Klara Rosta, Zahra Al-Aissa, Orsolya Hadarits, Jürgen Harreiter, Ákos Nádasdi, Dagmar Bancher-Todesca, László Németh, Péter Igaz, János Rigó Jr, István Sziller, Alexandra Kautzky-Willer, Anikó Somogyi
JournalInternational journal of molecular sciences (Int J Mol Sci) Vol. 19 Issue 12 (Nov 23 2018) ISSN: 1422-0067 [Electronic] Switzerland
PMID30477160 (Publication Type: Journal Article)
Chemical References
  • Biomarkers
  • Blood Glucose
  • Insulin
  • MTNR1B protein, human
  • Receptor, Melatonin, MT2
Topics
  • Adult
  • Alleles
  • Biomarkers
  • Blood Glucose
  • Body Mass Index
  • Diabetes, Gestational (drug therapy, etiology, metabolism)
  • Female
  • Genetic Variation
  • Humans
  • Insulin (therapeutic use)
  • Odds Ratio
  • Pharmacogenetics
  • Pregnancy
  • Receptor, Melatonin, MT2 (genetics)
  • Treatment Outcome

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