Lifestyle Intervention for Weight Loss and Cardiometabolic Changes in the Setting of Glucokinase Regulatory Protein Inhibition

Glucokinase Regulatory Protein-Leu446Pro Variant in Look AHEAD

Ligia Belalcazar, George D. Papandonatos, Bahar Erar, Inga Peter, Hadeel Alkofide, Ashok Balasubramanyam, Ariel Brautbar, Steven E. Kahn, William C. Knowler, Christie M. Ballantyne, Jeanne M. McCaffery, Gordon S. Huggins

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background-Glucokinase regulatory protein (GCKR) inhibitors offer a novel treatment approach for glucose control in diabetes mellitus; however, their cardiometabolic effects, particularly in relation to increased triglycerides and C-reactive protein (CRP) levels, are of concern. GCKR Leu446Pro is a common variant associated with reduced GCKR function, increased triglycerides, and CRP. Methods and Results-We investigated whether a 1-year intensive lifestyle intervention (ILI) for weight loss would avert the unfavorable cardiometabolic effects associated with GCKR Leu446Pro when compared with a diabetes mellitus support and education arm in overweight/obese individuals with type 2 diabetes mellitus with triglyceride (n=3214) and CRP (n=1411) data participating in a randomized lifestyle intervention study for weight loss, Action for Health in Diabetes Mellitus (Look AHEAD). Once demographics, medication use and baseline adiposity, and fitness were accounted for, ILI did not modify the baseline association of GCKR-Leu446Pro with elevated triglycerides (β±SE=0.067±0.013, P=1.5×10-7 and β±SE=0.052±0.015, P=5×10-4) or with elevated CRP (β±SE=0.136±0.034, P=5.1×10-5and β±SE=0.903±0.038, P=0.015) in the overall sample and Non-Hispanic Whites, respectively. The lack of a protective effect from ILI at 1 year when compared with diabetes mellitus support and education (ILI versus diabetes mellitus support and education interaction for triglyceride and CRP change, respectively: P=0.64 and 0.37 in the overall sample; P=0.27 and 0.05 in Non-Hispanic Whites) persisted after additional adjustment for changes in adiposity and fitness. Conclusions-Moderate improvements in adiposity and fitness with ILI did not mitigate the adverse cardiometabolic effects of GCKR inhibition in overweight/obese individuals with diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)71-78
Number of pages8
JournalCirculation: Cardiovascular Genetics
Volume9
Issue number1
DOIs
StatePublished - Feb 1 2016

Fingerprint

Life Style
Weight Loss
Diabetes Mellitus
C-Reactive Protein
Triglycerides
Adiposity
Education
Type 2 Diabetes Mellitus
Inhibition (Psychology)
glucokinase regulatory protein
Demography
Glucose
Health
Therapeutics

Keywords

  • behavioral intervention
  • C-reactive protein
  • diabetes mellitus
  • GCKR
  • lifestyle
  • obesity
  • triglycerides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)
  • Genetics

Cite this

Lifestyle Intervention for Weight Loss and Cardiometabolic Changes in the Setting of Glucokinase Regulatory Protein Inhibition : Glucokinase Regulatory Protein-Leu446Pro Variant in Look AHEAD. / Belalcazar, Ligia; Papandonatos, George D.; Erar, Bahar; Peter, Inga; Alkofide, Hadeel; Balasubramanyam, Ashok; Brautbar, Ariel; Kahn, Steven E.; Knowler, William C.; Ballantyne, Christie M.; McCaffery, Jeanne M.; Huggins, Gordon S.

In: Circulation: Cardiovascular Genetics, Vol. 9, No. 1, 01.02.2016, p. 71-78.

Research output: Contribution to journalArticle

Belalcazar, Ligia ; Papandonatos, George D. ; Erar, Bahar ; Peter, Inga ; Alkofide, Hadeel ; Balasubramanyam, Ashok ; Brautbar, Ariel ; Kahn, Steven E. ; Knowler, William C. ; Ballantyne, Christie M. ; McCaffery, Jeanne M. ; Huggins, Gordon S. / Lifestyle Intervention for Weight Loss and Cardiometabolic Changes in the Setting of Glucokinase Regulatory Protein Inhibition : Glucokinase Regulatory Protein-Leu446Pro Variant in Look AHEAD. In: Circulation: Cardiovascular Genetics. 2016 ; Vol. 9, No. 1. pp. 71-78.
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abstract = "Background-Glucokinase regulatory protein (GCKR) inhibitors offer a novel treatment approach for glucose control in diabetes mellitus; however, their cardiometabolic effects, particularly in relation to increased triglycerides and C-reactive protein (CRP) levels, are of concern. GCKR Leu446Pro is a common variant associated with reduced GCKR function, increased triglycerides, and CRP. Methods and Results-We investigated whether a 1-year intensive lifestyle intervention (ILI) for weight loss would avert the unfavorable cardiometabolic effects associated with GCKR Leu446Pro when compared with a diabetes mellitus support and education arm in overweight/obese individuals with type 2 diabetes mellitus with triglyceride (n=3214) and CRP (n=1411) data participating in a randomized lifestyle intervention study for weight loss, Action for Health in Diabetes Mellitus (Look AHEAD). Once demographics, medication use and baseline adiposity, and fitness were accounted for, ILI did not modify the baseline association of GCKR-Leu446Pro with elevated triglycerides (β±SE=0.067±0.013, P=1.5×10-7 and β±SE=0.052±0.015, P=5×10-4) or with elevated CRP (β±SE=0.136±0.034, P=5.1×10-5and β±SE=0.903±0.038, P=0.015) in the overall sample and Non-Hispanic Whites, respectively. The lack of a protective effect from ILI at 1 year when compared with diabetes mellitus support and education (ILI versus diabetes mellitus support and education interaction for triglyceride and CRP change, respectively: P=0.64 and 0.37 in the overall sample; P=0.27 and 0.05 in Non-Hispanic Whites) persisted after additional adjustment for changes in adiposity and fitness. Conclusions-Moderate improvements in adiposity and fitness with ILI did not mitigate the adverse cardiometabolic effects of GCKR inhibition in overweight/obese individuals with diabetes mellitus.",
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