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Type: Journal article
Title: A NOS3 Polymorphism Determines Endothelial Response to Folate in Children with Type 1 Diabetes or Obesity
Author: Wiltshire, E.
Peña, A.
MacKenzie, K.
Bose-Sundernathan, T.
Gent, R.
Couper, J.
Citation: Journal of Pediatrics, 2015; 166(2):319-325.e1
Publisher: Elsevier
Issue Date: 2015
ISSN: 0022-3476
Statement of
Esko J. Wiltshire, Alexia S. Peña, Karen MacKenzie, Tulika Bose-Sundernathan, Roger Gent, Jennifer J. Couper
Abstract: OBJECTIVE: To determine the effect of polymorphisms in NOS3 and folate pathway enzymes on vascular function and folate status and endothelial response to folate in children with diabetes or obesity. STUDY DESIGN: A total of 244 subjects (age 13.8 ± 2.8 years, 125 males) were studied for NOS3 and/or folate pathway polymorphisms using polymerase chain reaction/restriction fragment length polymorphism, including at baseline: 139 with type 1 diabetes; 58 with obesity; and 47 controls. The effect of NOS3 genotype on endothelial response to folate (5 mg) was assessed in 85 subjects with diabetes and 28 obese subjects who received active treatment during intervention trials. Vascular function (flow-mediated dilatation [FMD] and glyceryl trinitrate-mediated dilatation), clinical, and biochemical measurements were assessed at baseline and 8 weeks in folate intervention studies. RESULTS: Folate pathway enzyme and NOS3 polymorphisms did not significantly affect baseline vascular function. The polymorphism in intron 4 of endothelial nitric oxide synthase altered endothelial response to folate significantly: in subjects with diabetes FMD improved by 6.4 ± 5% (insertion carriers) vs 2.3 ± 6.6% (deletion carriers), P = .01; in obese subjects FMD improved by 1.8 ± 5.4% (insertion carriers) and deteriorated by -3.2 ± 7.2% (deletion carriers), P = .05. More subjects carrying the insertion normalized FMD after folate supplementation (insertion 64% vs deletion 28%, χ(2) = 10.14, P = .001). CONCLUSIONS: A NOS3 polymorphism predicts endothelial response to folate in children with diabetes or obesity, with implications for vascular risk and folate intervention studies.
Keywords: Endothelium, Vascular
Diabetes Mellitus, Type 1
Folic Acid
Polymorphism, Genetic
Nitric Oxide Synthase Type III
Rights: © 2015 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.jpeds.2014.10.050
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