Diabetes, Metabolic Syndrome and Obesity (Jun 2022)
Effect of Metformin on Glycemic Control Regarding Carriers of the SLC22A1/OCT1 (rs628031) Polymorphism and Its Interactions with Dietary Micronutrients in Type 2 Diabetes
Abstract
Eloy A Zepeda-Carrillo,1,2,* Omar Ramos-Lopez,3 Erika Martínez-López,4 Elisa Barrón-Cabrera,5 J Antonio Bernal-Pérez,6 Luisa E Velasco-González,6 Ernesto Rangel-Rios,6 J Fausto Bustamante Martínez,2 Rafael Torres-Valadez1,7,* 1Specialized Unit in Research, Development and Innovation in Genomic Medicine, Nayarit Center for Innovation and Technology Transfer, Autonomous University of Nayarit, Tepic, Nayarit, Mexico; 2Civil Hospital “Dr. Antonio González Guevara”, Health Services in Nayarit, Tepic, Nayarit, Mexico; 3Medicine and Psychology School, Autonomous University of Baja California, Tijuana, B.C, Mexico; 4Institute of Translational Nutrigenetics and Nutrigenomics, Department of Molecular and Genomic Biology, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, Mexico; 5Faculty of Nutrition and Gastronomy Sciences, Autonomous University of Sinaloa, Culiacan, Sinaloa, Mexico; 6Family Medicine Unit No. 24 “Ignacio García Téllez”, Mexican Social Security Institute, Tepic, Nayarit, Mexico; 7Integral Health Academic Unit, Autonomous University of Nayarit, Tepic, Nayarit, Mexico*These authors contributed equally to this workCorrespondence: Rafael Torres-Valadez, Nayarit Center for Innovation and Technology Transfer, Autonomous University of Nayarit, Tepic, Nayarit, Mexico, Tel +52-3312523644, Email [email protected]: Differences in metformin effect on glycemic control in type 2 Diabetes (T2D) have been associated with diet, obesity, years since T2D diagnosis and genetic factors, such as the Met408Val (rs628031) SLC22A1/OCT1 gene polymorphism. This study aimed to analyze the effect of metformin and diet on glycemic control and its association with the Met408Val polymorphism in patients with T2D from western Mexico.Patients and Methods: A total of 240 T2D adult patients were enrolled in this cross-sectional study. Anti-hyperglycemic therapy, dietary intake, body composition and glycemic profile were recorded and the determination of genotypes of SLC22A1/OCT1 gene (rs628031) was performed using an allelic discrimination assay.Results: The type of metformin therapy was 47% monotherapy, 45% dual therapy (metformin+glibenclamide or metformin+insulin) and 8% triple therapy (metformin+glibenclamide+insulin). Individuals with metformin monotherapy had a higher glycemic control frequency (%HbA1c < 7.0) compared with the dual and triple treatment schemes (77% vs 35% and 15%, respectively; p< 0.001). Interestingly, a high potassium intake was documented in the three anti-hyperglycemic therapies and a lower intake of micronutrients, including calcium, magnesium, and zinc. An interaction was found between calcium intake and carriers of the risk allele A (408Val) with %HbA1c (P interaction=0.028), and potassium intake with the TyG index (P interaction=0.027). In addition, there was a positive correlation between calcium intake and %HbA1c (r=0.682; p=0.010), and potassium intake vs TyG index (r=0.593; p=0.033) in risk allele A (408Val) carriers with metformin monotherapy. Genotype frequencies were GG homozygotes (76.6%), GA heterozygotes (21.5%) and AA homozygotes (1.9%). The allele frequency was 87.4% for the ancestral allele G and 12.6% for the risk allele A.Conclusion: These findings suggest a differing effect of metformin on glycemic control regarding calcium and potassium intake and the Met408Val SLC22A1/OCT1 gene polymorphism in T2D patients.Keywords: nutrigenetic, pharmacogenetic, SLC22A1/OCT1 gene, gene-nutrient interactions, calcium intake, potassium intake
