Aims/hypothesis. The sulphonylurea receptor is a subunit of the ATP-sensitive potassium channel in the pancreatic beta cell. Mutations at
nt –3 of the splice acceptor site of exon 16 and a silent mutation in exon 18 of the gene for the sulphonylurea receptor (
SUR1) associate with Type II (non-insulin-dependent) diabetes mellitus in several independent populations. We investigated whether
these gene variants associate with changes in the pattern of glucose-stimulated insulin secretion.¶
Methods. Subjects who had normal glucose tolerance (
n = 67) and subjects with an impaired glucose tolerance (
n = 94), originating from two independent studies, were included in the study. Beta-cell function and insulin sensitivity were
assessed by the hyperglycaemic clamp.¶
Results. Frequencies of the exon 16 –3
t allele in the normal and impaired glucose tolerant groups were 46 % and 44 % respectively (
p = NS). The more rare exon 18 T allele showed frequencies of 5 and 7 % respectively (
p = NS). We observed an approximately 25 % reduced second-phase insulin secretion in carriers of the exon 16 –3
t allele in both groups (
p < 0.05). Estimates of insulin sensitivity did not show differences between carriers and non-carriers. The variant in exon
18 and the combined presence of variants in exon 16 and exon 18 were not associated with differences in insulin secretion
or insulin sensitivity in our study groups.¶
Conclusion/interpretation. The diabetes associated exon 16 –3
t variant of the
SUR1 gene associates with a functional change of the beta cell as reflected by reduced second-phase insulin secretion in response
to a standardized hyperglycaemia in normal and impaired glucose tolerant subjects. [Diabetologia (2000) 43: 515–519]
Keywords Type II diabetes mellitus, sulphonylurea receptor, genetics, insulin, beta cell, insulin secretion, impaired glucose
tolerance, hyperglycaemic clamp.
Received: 5 July 1999 and in revised form: 24 November 1999