Variation in the glucose transporter gene SLC2A2 is associated with glycemic response to metformin.

Nat Genet
Authors
Abstract

Metformin is the first-line antidiabetic drug with over 100 million users worldwide, yet its mechanism of action remains unclear. Here the Metformin Genetics (MetGen) Consortium reports a three-stage genome-wide association study (GWAS), consisting of 13,123 participants of different ancestries. The C allele of rs8192675 in the intron of SLC2A2, which encodes the facilitated glucose transporter GLUT2, was associated with a 0.17% (P = 6.6 × 10(-14)) greater metformin-induced reduction in hemoglobin A1c (HbA1c) in 10,577 participants of European ancestry. rs8192675 was the top cis expression quantitative trait locus (cis-eQTL) for SLC2A2 in 1,226 human liver samples, suggesting a key role for hepatic GLUT2 in regulation of metformin action. Among obese individuals, C-allele homozygotes at rs8192675 had a 0.33% (3.6 mmol/mol) greater absolute HbA1c reduction than T-allele homozygotes. This was about half the effect seen with the addition of a DPP-4 inhibitor, and equated to a dose difference of 550 mg of metformin, suggesting rs8192675 as a potential biomarker for stratified medicine.

Year of Publication
2016
Journal
Nat Genet
Volume
48
Issue
9
Pages
1055-9
Date Published
2016 Sep
ISSN
1546-1718
DOI
10.1038/ng.3632
PubMed ID
27500523
PubMed Central ID
PMC5007158
Links
Grant list
U01 DK048437 / DK / NIDDK NIH HHS / United States
U01 DK048406 / DK / NIDDK NIH HHS / United States
U01 DK048407 / DK / NIDDK NIH HHS / United States
U01 DK048412 / DK / NIDDK NIH HHS / United States
U01 DK048375 / DK / NIDDK NIH HHS / United States
U01 DK048434 / DK / NIDDK NIH HHS / United States
U01 DK048413 / DK / NIDDK NIH HHS / United States
092272 / Wellcome Trust / United Kingdom
10/0004063 / Diabetes UK / United Kingdom
102820 / Wellcome Trust / United Kingdom
U01 DK048397 / DK / NIDDK NIH HHS / United States
U01 DK048381 / DK / NIDDK NIH HHS / United States
U01 DK048514 / DK / NIDDK NIH HHS / United States
U01 DK048485 / DK / NIDDK NIH HHS / United States
U01 DK048411 / DK / NIDDK NIH HHS / United States
U01 DK048443 / DK / NIDDK NIH HHS / United States
U01 DK048380 / DK / NIDDK NIH HHS / United States
U01 DK048400 / DK / NIDDK NIH HHS / United States
U19 GM061390 / GM / NIGMS NIH HHS / United States
R01 GM117163 / GM / NIGMS NIH HHS / United States
U01 DK048468 / DK / NIDDK NIH HHS / United States
U01 DK048387 / DK / NIDDK NIH HHS / United States
U01 DK048404 / DK / NIDDK NIH HHS / United States
U01 DK048489 / DK / NIDDK NIH HHS / United States
U01 DK048349 / DK / NIDDK NIH HHS / United States
U01 DK048377 / DK / NIDDK NIH HHS / United States
P30 DK017047 / DK / NIDDK NIH HHS / United States