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DOI: 10.1055/s-0029-1220902
© Georg Thieme Verlag KG Stuttgart · New York
The T393C Polymorphism of the Gαs Gene (GNAS1) is Associated with the Course of Graves' Disease
Publication History
received 13.02.2009
accepted 20.04.2009
Publication Date:
09 June 2009 (online)
Abstract
Genotypes of the T393C SNP of GNAS1, a gene that encodes for the Gαs subunit of G proteins have been significantly associated with the clinical course in a variety of cancers. Since this SNP may also influence the course of Graves’ disease (GD) and, especially, Graves’ ophthalmopathy (GO), we determined genotype and allele frequency in a series of 359 patients, which were referred to our clinic within 6 months of the onset of GO. Among them, 336 patients also suffered from associated hyperthyroidism. Data on relapse and remission rates 12 months after termination of a 1 year antithyroid drug therapy was available for 276 patients. As controls, 820 healthy individuals were recruited. Our data suggest that the T393C SNP does not represent a risk factor for the development of both GD and GO. It was, however, significantly associated with the course of hyperthyroidism (p=0.013) and a similar trend was evident for the course of GO (p=0.093). Homozygous TT carriers showed a significantly increased risk (p=0.03) for hyperthyroidism to relapse (OR 2.4; 95% CI 1.1–5.4). Also, the TT genotype was associated with significantly increased serum TRAb levels (CC+CT: 5.4 IU/l vs. TT: 9.3 IU/l). This is probably caused by increased G-Protein susceptibility to TSHR-mediated stimulation through TRAb. Genotyping of the T393C SNP of GNAS1 may become a useful additional tool to predict the clinical course of GD and GO. This may allow the clinician to identify patients at risk for more severe courses of disease and to come to more timely decisions for treatment.
Key words
GNAS1 T393C single nucleotide polymorphism - Graves’ disease - Graves’ ophthalmopathy - prognosis
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Correspondence
A. K. EcksteinMD
Department of Ophthalmology
University Hospital of Essen
Hufelandstraße 55
45122 Essen
Germany
Phone: +49/201/723 29 07
Fax: +49/201/723 56 41
Email: anja.eckstein@uk-essen.de