제2형 당뇨병 환자에서 Rosiglitazone 투여 후 체중변화에 Proa12Ala PPAR γ이형성이 미치는 영향

초록

The Pro12Ala polymorphism of the gene encoding the peroxisome proliferator-activated receptor(PPAR)γ2 has recently been shown to be associated with insulin sensitivity. Rosiglitazone(RSG) is known as a potent agonist for the PPARγ. It improves glycemic control by improve insulin sensitivity in peripheral tissues. This study was performed to evaluate the role of PPARγ2 polymorphism, Pro12Ala as an indicator to predict the clinical response of RSG in type 2 diabetes patients. Method: The study subjects were 250 type 2 diabetic patients(65 male, 60 female) who were received 1 year course of daily 4 mg RSG combined with sulfonylurea or metformin. The Pro12Ala polymorphism of the PPARγ2 was determined by the RFLP method. Body weights, height, waist circumference, fasting glucose, insulin, c-peptide and lipid profile were measured. Results: The allele frequency of the Ala12Pro polymorphism of the PPARγ2 was 0.016. After RSG treatment, body weight change was 2.4%, 4.5% of baseline body weight at 12, 24 weeks respectively. Body weight gains were increased to 5.6% at the end of 1 year. The HbA1C, serum insulin level and HOMA index were decreased following the rosiglitazone therapy. The Ala12Pro variant of the PPARγ2 was not associated with the clinical response of RSG. Body weight gain was correlated with basal fasting glucose, post-prandial 2 hour glucose and HbA1c level(p<0.05). There was no correlation between baseline body weight and gain change. Conclusion: This results showed that Pro12Ala polymorphism was not acceptable for the predictor of rosiglitazone induced weight gain and clinical response.