The epigenetic role of family history: A possible link between genetic and enviromental factors in onset of diabetic retinopathy

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 818-841-Diabetes Pathophysiology & Complications
Basic/Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-840
Zhila Maghbooli*1, Arash Hossein-nezhad2, Bagher Larijani3 and Parvin Pasalar4
1Endocrinolog and metabolism research institue, Tehran, Iran, 2Boston University School of Medicine, Boston, 3Endo and Metabolism Research Ins, Tehran, Iran, 4Tehran University, Tehran
Background: Complex multifactorial diseases have been attributed to epigenetic modifications in response to the environmental changes. Recent documents support that epigenetic mechanisms are important components in metabolic memory and the pathology of diabetic complications. A family history of diabetes suggests familial genetic and epigenetic contributions to the disease complications. The aim of this study was to investigate the role of family history on diabetic retinopathy in type 2 diabetic patients.

Methods: A historical cohort study was performed on 948 adults with type 2 diabetes mellitus recruited from the diabetes referral clinic of the Tehran University of Medical Sciences over a six-month period (from July to December, 2012).  Diabetic risk factors and its complications, related laboratory characters were evaluated.

Results: Of the 948 diabetic patients 54%, were women, and the mean age was 58.47±9.91 years. The mean duration of diabetes was 11.59±7.9 years (range: 1-41 years). The prevalence of diabetes risk factors including dyslipidemia (TG>250 and/or HDL<35), hypertension (BP> 140/90 mmHg or taking BP medication), and obesity (BMI≥25kg/m2) was 23.8%, 75.3% and 74.5%, respectively. Poor control of glycemia (HbA1c≥7%) was observed on 58.6% of patients. At least one chronic complication (cardiovascular diseases, retinopathy, and nephropathy) was diagnosed in 384 diabetic patients (44.1%).

               The prevalence of diabetes nephropathy, cardiovascular diseases and diabetes retinopathy were 9.3%, 15.8%, and 28%, respectively. Among all patients, there were significant associations between retinopathy and a family history of diabetes (p=0.019), hypertension (p=0.0001) and the mean age at diabetes diagnosis (p=0.0001) compare to patients without retinopathy. However, no significant associations were found between retinopathy with dyslipidemia and obesity.

               Poor glycemic control was observed in 70.9% patients with retinopathy compare to 53.2% in patients without retinopathy (p=0.0001,). In logistic regression model, glycemic control (OR 1.41 p=0.009), hypertension (OR 2.99 p=.0001), duration of diabetes ≥10 years (OR 4.27, p=.0001) and family history of diabetes (OR 1.7, p=0.007) were independently predict retinopathy after adjustment for age and sex. In this model, no significant relationships were observed for obesity and dyslipidemia.

Discussion: Family history of diabetes as a link between genetic and environmental factor was important to predict diabetic retinopathy. Therefore, these finding indicate that the role of family history in epigenetic modification, and potential metabolic memory in diabetic complications.

Nothing to Disclose: ZM, AH, BL, PP

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm