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Sudden Death in Diabetics Tied to Genetic Polymorphism

Posted: Thursday, December 20, 2007

The cholesterol ester transfer protein (CETP) TaqIB polymorphism is associated with the risk of sudden death in type 2 diabetic patients, according to French researchers.

The increased risk of sudden death in diabetics has been partly attributed to low HDL cholesterol; and "CETP plays a key role in HDL metabolism and reverse cholesterol transport," the investigators point out. This and other observations prompted the physicians to take a closer look at the relationship of CETP, CHD and sudden death in diabetes.

Dr. Frederic Fumeron, senior investigator writes, "This polymorphism does not allow us to separate the population into two groups, those who will die from sudden death and those who will not." "We can see that 44% of those who will die from sudden death carry the 'bad' genotype, but 35% who carry this genotype will not."

"Nevertheless," he continued, "it indicates that the CETP pathway is involved in coronary complications (for) type 2 diabetic patients."

Dr. Fumeron of Xavier Bichat Medical School, Paris and colleagues came to this conclusion after genotyping more than 3100 diabetics who were at high cardiovascular risk.

The incidence of coronary heart disease was higher in B1B1 homozygotes than in B2 carriers and such homozygotes had a greater risk of sudden death (hazard ratio, 1.51), according to the report in the November issue of Diabetes Care.

"The effect on sudden death is more significant," continued Dr. Fumeron, "but the same trend can be seen in myocardial infarction."

The allele associated with increased risk -- B1-- is "associated with an increase in CETP activity. Therefore, it indicates that CETP inhibition could be a therapeutic target, at least in these high-risk patients."

Source: Diabetes In Control: Diabetes Care 2007;30:2863-2867.