10:56 AM PDT, September 17, 2010
British researchers reported Friday that it may be possible to identify people who are going to develop Type 2 diabetes even before symptoms occur. If the test can be verified, it might be possible to screen people who are at higher-than-normal risk of developing diabetes and intervene before symptoms, and the broad spectrum of complications that accompany them, occur.
Triggered by increases in obesity, Type 2 diabetes is becoming a major health problem, with an estimated 285 million people worldwide now affected by the disease -- a number that is expected to grow to 400 million by 2030. In the United States alone, there are 21 million Type 2 diabetics, presenting a major burden to the healthcare system. Complications of the disorder include cardiovascular disease, kidney failure, stroke, peripheral nerve damage and blindness.
In recent years, there has been growing interest in microRNAs, small chains of ribonucleic acid (RNA) that are found in cells and the blood. Messenger RNA's normal role in the cell is to transmit information about protein structures from the DNA blueprint in a cell's nucleus to the protein-making machinery. MicroRNAs, first discovered in 1993, are shorter than messenger RNA and researchers now believe that they play a key role in protein production by blocking the activity of messenger RNA -- in effect, turning genes off. They are now known to be involved in a variety of physiological processes, playing a previously unsuspected role.
Dr. Manuel Mayr of the British Heart Foundation Centre at King's College London and his colleagues investigated the potential role of microRNAs in diabetes. Their subjects were participants in the so-called Bruneck Study, a long-term examination of the residents of the city of Bruneck in the Bolzano Province of Italy. The Bruneck Study, much like the famous Framingham Study in the United States, was initially designed to study the pathogenesis of cardiovascular disease and subsequently extended to include a broad variety of disease. Blood samples were initially collected and stored in 1990 and at regular intervals since. The subjects' health has also been monitored.
Mayr's team reported in Circulation Research: Journal of the American Heart Assn. that, in a study of 822 residents, they identified five specific microRNAs whose concentration in blood was abnormally low in people with diabetes and in those who subsequently went on to develop the disorder. One in particular, called microRNA 126, was among the most reliable predictors of current and future diabetes, they said. MicroRNA 126 is known to help form new blood vessels and regulate their maintenance and its loss may be an indicator of blood vessel damage and cardiovascular disease. They subsequently showed that levels of the marker were also reduced when large amounts of sugar were given to mice with a genetic propensity to develop diabetes.
They are now planning a larger study to validate their findings.
-- Thomas H. Maugh II / Los Angeles Times
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