Aims/hypothesis. Insulin resistance is recognised as the core factor in the pathogenesis of Type II (non-insulin-dependent) diabetes mellitus,
hypertension and atherosclerosis. Several studies indicate the possible role of mutations of the insulin receptor substrate-1
(
IRS-1) gene in the pathogenesis of insulin-resistance and suggest a possible interaction between the
IRS-1 gene and obesity, either by an effect on the development of obesity or by causing or aggravating the obesity-associated insulin
resistance. Therefore, the prevalence of the
G972R mutation of the
IRS-1 gene was compared in 157 non-diabetic obese subjects (BMI > 30 m/kg
2) and in 157 lean subjects (BMI < 28 m/kg
2). By investigating the relation between this
IRS-1 mutation, measures of obesity and metabolic parameters, we explored the possible influence of this mutation on body fat distribution
and insulin resistance.
Methods. The
G972R mutation was detected by PCR amplification and BstN-1 restriction enzyme digestion. Data were analysed by univariate and
multivariate analysis.
Results. The
G972R allele was significantly more frequent in obese subjects than in lean subjects (
p < 0.002); however, no difference was found between centrally and peripherally obese subjects. Obese
G972R carriers had significantly higher BMI (
p < 0.001), fasting insulin (
p < 0.01), triglycerides (
p < 0.03) and HOMA
IR (
p < 0.001) than obese non-carriers. No differences were observed between
G972R carriers and non-carriers among control subjects. Multivariate analysis confirmed that the
IRS-1 G972R mutation was significantly and independently associated with reduced insulin sensitivity (
p < 0.009) in the obese group.
Conclusion/interpretation. The
G972R mutation of the
IRS-1 gene associates with obesity, but not with fat distribution, in this Italian cohort, and within the obese subjects this
IRS-1 variant strongly associates with metabolic parameters suggesting greater insulin-resistance. These findings indicate a possible
interaction between the
IRS-1 variant and obesity in worsening insulin sensitivity. [Diabetologia (2001) 44: 367–372]
Keywords HOMAIR - IRS-1 - BMI - Type II diabetes - central obesity - peripheral obesity - bioeletric impedance - G972R.