The two incretins, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), are insulinotropic
factors released from the small intestine to the blood stream in response to oral glucose ingestion. The insulinotropic effect
of GLP-1 is maintained in patients with Type II (non-insulin-dependent) diabetes mellitus, whereas, for unknown reasons, the
effect of GIP is diminished or lacking. We defined the exon-intron boundaries of the human GIP receptor, made a mutational
analysis of the gene and identified two amino acid substitutions, A207 V and E354Q. In an association study of 227 Caucasian
Type II diabetic patients and 224 matched glucose tolerant control subjects, the allelic frequency of the A207 V polymorphism
was 1.1 % in Type II diabetic patients and 0.7 % in control subjects (
p = 0.48), whereas the allelic frequency of the codon 354 polymorphism was 24.9 % in Type II diabetic patients versus 23.2
% in control subjects. Interestingly, the glucose tolerant subjects (6 % of the population) who were homozygous for the codon
354 variant had on average a 14 % decrease in fasting serum C-peptide concentration (
p = 0.01) and an 11 % decrease in the same variable 30 min after an oral glucose load (
p = 0.03) compared with subjects with the wild-type receptor. Investigation of the function of the two GIP receptor variants
in Chinese hamster fibroblasts showed, however, that the GIP-induced cAMP formation and the binding of GIP to cells expressing
the variant receptors were not different from the findings in cells expressing the wild-type GIP receptor. In conclusion,
amino acid variants in the GIP receptor are not associated with random Type II diabetes in patients of Danish Caucasian origin
or with altered GIP binding and GIP-induced cAMP production when stably transfected in Chinese hamster fibroblasts. The finding
of an association between homozygosity for the codon 354 variant and reduced fasting and post oral glucose tolerance test
(OGTT) serum C-peptide concentrations, however, calls for further investigations and could suggest that GIP even in the fasting
state regulates the beta-cell secretory response. [Diabetologia (1998) 41: 1194–1198]
Keywords Type II diabetes mellitus - genetics - GIP receptor - mutations - incretins - C-peptide response - transfections.
Received: 13 February 1998 and in final revised form: 29 May 1998