Summary:
Glucagon-like peptide 1 (GLP-1) has antidiabetic effects and many facets of Type 2 diabetes could theoretically be the consequence of a reduction in or lack of GLP-1 function. Exogenous GLP-1 is exquisitely effective in Type 2 diabetic patients, making receptor defects unlikely. GLP-1 responses after meals as detected by radioimmunoassay are not overtly reduced in Type 2 diabetic patients. Therefore, a sequence analysis of exon 2 of the preproglucagon gene coding for the GLP-1 protein was initiated in order to exclude potential germline mutations. 24 Type 2 diabetic patients and in 14 control subjects with normal oral glucose tolerance (WHO criteria) were studied. In all specimens of peripheral blood leukocyte DNA examined, no germline mutations of the GLP-1 sequence were identified, thus excluding mutations in the GLP-1 sequence as a major contributor to the pathophysiological appearance of the Type 2 diabetic phenotype. Rare mutations, however, cannot be excluded due to the small number of Type 2 diabetic patients examined.
Key words:
Type 2 diabetes - genetics - glucagon-like peptide 1 (GLP-1) - gastric inhibitory polypeptide (GIP) - incretin - insulin secretion
References
-
1
Bell G I, Sanchez-Pescador R, Laybourn P J, Najarian R C.
Exon duplication and divergence in the human preproglucagon gene.
Nature.
304
368-371
1983;
-
2
Cox N J, Xiang K-S, Fajans S.
Bell GI: Mapping diabetes-susceptibility genes. Lessons learned from search for DNA marker for maturity-onset diabetes of the young.
Diabetes.
41
401-407
1992;
-
3
Fehmann H C, Gherzi R, Göke B.
Regulation of islet hormone gene expression by incretin hormones.
Exp Clin Endocrinol Diabetes.
103 Suppl 2
56-65
1995;
-
4
Gutniak M K, Holst J J, Ørskov C, Åhren B, Efendic S.
Antidiabetogenic effect of glucagon-like peptide-1 (7-36)amide in normal subjects and patients with diabetes mellitus.
N Engl J Med..
326
1316-1322
1992;
-
5
Holst J J, Orskov C, Vagn-Nielsen O, Schwartz T W.
Truncated glucagon-like peptide 1, an insulin-releasing hormone from the distal gut.
FEBS Letters..
211
169-174
1987;
-
6
Kolligs F, Fehmann H C, Göke R, Göke B.
Reduction of the incretin effect in rats by the glucagon-like peptide 1 receptor antagonist exendin (9-39) amide.
Diabetes.
44
16-19
1995;
-
7
Komatsu R, Matsuyama T, Namba M. et al. .
Glucagonostatic and insulinotropic action of glucagonlike peptide I-(7-36)-amide.
Diabetes.
38
902-905
1989;
-
8
Kreymann B, Williams G, Ghatei MA, Bloom SR.
Glucagon-like peptide-1 [7-36]: a physiological incretin in man.
Lancet.
2
1300-1304
1987;
-
9
Mojsov S, Weir G C, Habener J F.
Insulinotropin: glucagon-like peptide I (7-37) co-encoded in the glucagon gene is a potent stimulator of insulin release in the perfused rat pancreas.
J Clin Invest.
79
616-619
1987;
-
10
Nathan D M, Schreiber E, Fogel H, Mojsov S, Habener J F.
Insulinotropic action of glucagon-like peptide 1 (7-37) in diabetic and non-diabetic subjects.
Diabetes Care.
15
270-276
1992;
-
11
Nauck M A, Bartels E, Ørskov C, Ebert R, Creutzfeldt W.
Additive insulinotropic effects of exogenous synthetic human gastric inhibitory polypeptide and glucagon-like peptide-1-(7-36) amide infused at near-physiological insulinotropic hormone and glucose concentrations.
J Clin Endocrinol Metab.
76
912-917
1993a;
-
12
Nauck M A, Heimesaat M M, Ørskov C, Holst J J, Ebert R, Creutzfeldt W.
Preserved incretin activity of glucagon-like peptide 1 [7-36 amide] but not of synthetic human gastric inhibitory polypeptide in patients with type-2 diabetes mellitus.
J Clin Invest.
91
301-307
1993b;
-
13
Nauck M A, Kleine N, Ørskov C, Holst J J, Willms B, Creutzfeldt W.
Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients.
Diabetologia.
36
741-744
1993c;
-
14
Nauck M A, Niedereichholz U, Ettler R. et al. .
Glucagon-like peptide 1 inhibition of gastric emptying outweighs its insulinotropic effects in healthy humans.
Am J Physiol.
273
E981-988
1997;
-
15
Ørskov C.
Glucagon-like peptide-1, a new hormone of the entero-insular axis.
Diabetologia.
35
701-711
1992;
-
16
Ørskov C, Holst J J, Nielsen O V.
Effect of truncated glucagon-like peptide-1 [proglucagon-(78-107) amide] on endocrine secretion from pig pancreas, antrum, and nonantral stomach.
Endocrinology.
123
2009-2013
1988;
-
17
Ørskov C, Jeppesen J, Madsbad S, Holst J J.
Proglucagon products in plasma of noninsulin-dependent diabetics and nondiabetic controls in the fasting state and after oral glucose and intravenous arginine.
J Clin Invest.
87
415-423
1991;
-
18
Ørskov C, Knuhtsen S, Baldissera F G, Poulsen S S, Nielsen O V, Holst J J.
Glucagon-like peptides GLP-1 and GLP-2, predicted products of the glucagon gene, are secreted separately from pig small intestine but not pancreas.
Endocrinology.
119
1467-1475
1986;
-
19
Sauerwald A, Hahn S, Schmiegel W, Nauck M.
Fehlen von Mutationen im Proglucagon-Exon, das für GLP-1 codiert, bei Patienten mit Typ II-Diabetes.
Diabetes Stoffw..
6 (Suppl. 1)
97
1997;
-
20
Stoffel M, Espinosa R d, Le Beau M M, Bell G I.
Human glucagon-like peptide-1 receptor gene. Localization to chromosome band 6p21 by fluorescence in situ hybridization and linkage of a highly polymorphic simple tandem repeat DNA polymorphism to other markers on chromosome 6.
Diabetes.
42
1215-1218
1993;
-
21
Turner R C, Hattersley A T, Shaw J TE, Levy J C.
Type II diabetes: Clinical aspacts of molecular biological studies.
Diabetes.
44
1-10
1995;
-
22
Turton M D, O'Shea D, Gunn I. et al. .
A role for glucagon-like peptide-1 in the central regulation of feeding.
Nature.
379
69-72
1996;
-
23
Valverde I, Villanueva Penacarrillo M L.
In vitro insulinomimetic effects of GLP-1 in liver, muscle and fat.
Acta Physiol Scand..
157
359-360
1996;
-
24
Vionnet N, Hani E H, Lesage S. et al. .
Genetics of NIDDM in France. Studies with 19 candidate genes in affected sib pairs.
Diabetes.
46
1062-1068
1997;
-
25
Walsh P S, Metzger D A, Higuchi R.
Chelex 100 as a medium for simple extraction of DNA for PCR-based typing from forensic material.
BioTechniques.
10
506-513
1991;
-
26
Wang Z, Wang R M, Owji A A, Smith D M, Ghatei M A, Bloom S R.
Glucagon-like peptide-1 is a physiological incretin in rat.
J Clin Invest..
95
417-421
1995;
-
27
Willms B, Werner J, Holst J J, Ørskov C, Creutzfeldt W, Nauck M A.
Gastric emptying, glucose responses, and insulin secretion after a liquid test meal: effects of exogenous glucagon-like peptide-1 (GLP-1)-(7-36) amide in type 2 (noninsulin-dependent) diabetic patients.
J Clin Endocrinol Metab..
81
327-332
1996;
Prof. Dr. med. Michael Nauck
Medizinische Universitätsklinik
Knappschaftskrankenhaus
In der Schornau 23-25
D-44892 Bochum
Telefon: 0234-299-3412
Fax: 0234-299-3409
eMail: Michael.Nauck@ruhr-uni-bochum.de