INTERMEDIATE PHENOTYPE AND RISK OF DIABETIC NEPHROPATHY

产品说明：（改编自申请人摘要）强有力的证据表明，长期公认的30 - 40%的1型糖尿病（DM）患者具有肾病的特定风险，因为两个因素，血糖控制和基因。 遗传因素似乎涉及高血压过程，因为它们与高血压家族史和红细胞Na：Li反向转运增加有关。 涉及肾素-血管紧张素系统（RAS）的几个基因已成为详细研究的有吸引力的候选者，包括涉及血管紧张素原基因、ACE和AT1受体的多态性。 复杂人类特征的成功遗传分析的主要障碍是它们的多因素决定，特别是病因异质性。 因此，单独使用远缘表型作为二分性状的进展有限。增加病因同质性的一种有效方法是采用中间表型，其是鉴定患者的特定子集与感兴趣基因相关的生理或生化特征。 中间表型还可以提供对负责的生理机制的洞察。 本研究的目的是确定一个或多个基因的多态性是否与血管紧张素介导的肾循环控制的改变有关，血管紧张素介导的肾循环控制易患糖尿病肾病，并阐明基因，血糖控制和这些生理异常的表达之间的相互作用。 与特定遗传多态性相关的中间表型的成功鉴定将提供对当前治疗的深入了解、鉴定特定风险患者的新方法和改进的预防措施。

DESCRIPTION: (Adapted from the applicant's abstract) Strong evidence indicates that the long-recognized 30-40% of patients with type 1 diabetes mellitus (DM) who are at specific risk of nephropathy carry that risk because of two factors, glycemic control and genes. The genetic contributors appear to involve the hypertension process as they are associated with a strong family history of hypertension and increased red blood cell Na:Li countertransport. Several genes involving the renin-angiotensin system (RAS) have emerged as attractive candidates for detailed study, including polymorphism involving the angiotensinogen gene, ACE, and the AT1 receptor. A major barrier to successful genetic analysis of complex human traits is their multifactorial determination, specifically etiologic heterogeneity. Thus, the sole use of the distant phenotype as a dichotomous trait has limited progress. One powerful approach to increased etiologic homogeneity is to employ intermediate phenotypes, which are physiological or biochemical traits that identify specific subsets of patients for correlation with the gene of interest. The intermediate phenotype can also provide insight into the responsible physiological mechanisms. This study is designed to ascertain whether polymorphism in one or more of these genes in an epistatic relationship is associated with an alteration in angiotensin-mediated control of the renal circulation that predisposes to diabetic kidney disease, and to clarify the interaction between genes, glycemic control and expression of these physiologic abnormalities. Successful identification of intermediate phenotypes linked to specific genetic polymorphism would provide insight into current therapy, new approaches to identification of patients specifically at risk and improved preventative measures.