Decoding Connections between Diabetes and Heart Health
Alessandro Doria, M.D., Ph.D., M.P.H.
Wednesday, May 11, 2011
“If we can find genes that predispose people with type 2 diabetes to cardiovascular complications, we will learn more about the mechanisms responsible for the disease,” says Alessandro Doria, M.D., Ph.D., M.P.H.
“Even genetic variants that have minor effects on risk may be important,” Dr. Doria says, “because they may highlight targets for drug interventions. If we find variants with larger effects, we also could use this information to create genetic tests that can identify people whose cardiovascular risk is particularly high.”
“The way we do these studies has changed dramatically in the past few years,” the Joslin scientist notes. “We now have the ability to screen the entire genome systematically for association with a disease. In this way you can come across genes and molecular processes that are completely unsuspected.”
“There’s a lot of potential for novelty, but discovery is not as easy as it might seem,” Dr. Doria adds. “The first step is to find which regions of the genome are associated with the disease. Next is to find which genes in those regions are responsible for the association. And once you have those genes, the third step is understanding the mechanisms by which they influence cardiovascular disease. So the initial genetic study is just the beginning of a long march.”
In one early result of that march, he and his colleagues showed that a common genetic variant that increases coronary artery disease in the general population is particularly worrisome when it shows up among people with diabetes that is under poor control.
“If you have both of these problems, the risk skyrockets,” says Dr. Doria. “Knowing that their risks are particularly high, however, can help people in this situation to make lifestyle changes that may be beneficial.”
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