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Published in: Diabetologia 11/2006

01-11-2006 | Article

Phosphatidylinositol 3-kinase p85α regulatory subunit gene PIK3R1 haplotype is associated with body fat and serum leptin in a female twin population

Authors: Y. Jamshidi, H. Snieder, X. Wang, M. J. Pavitt, T. D. Spector, N. D. Carter, S. D. O’Dell

Published in: Diabetologia | Issue 11/2006

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Abstract

Aims/hypothesis

Phosphatidylinositol 3-kinase (PI3K) couples the leptin and insulin signalling pathways via the insulin receptor substrates IRS1 and IRS2. Hence, defective activation of PI3K could be a novel mechanism of peripheral leptin or insulin resistance. We investigated associations of tagging single-nucleotide polymorphisms (tSNPs) in the PI3K p85α regulatory subunit gene PIK3R1 with anthropometry, leptin, body fat and insulin sensitivity in a female twin population of European extraction.

Materials and methods

Eight tSNPs were genotyped in 2,778 women (mean age 47.4±12.5 years) from the St Thomas’ UK Adult Twin Registry (Twins UK).

Results

SNP rs1550805 was associated with serum leptin (p=0.028), BMI (p=0.025), weight (p=0.019), total fat (p=0.004), total fat percentage (p=0.002), waist circumference (p=0.025), central fat (p=0.005) and central fat percentage (p=0.005). SNPs rs7713645 and rs7709243 were associated with BMI (p=0.020 and p=0.029, respectively), rs7709243 with weight, total and central fat (p=0.026, p=0.031 and p=0.023, respectively) and both SNPs with fasting glucose (p=0.003 and p=0.001, respectively) and glucose 2-h post OGTT (p=0.023 and p=0.007, respectively). Subjects with haplotype 222 (frequency 7.2%) showed higher serum leptin concentration (p=0.007) and body fat measures (p≤0.001 for all), and those with haplotype 221 (frequency 38.7%) showed higher fasting and 2-h glucose (p=0.035 and p=0.021, respectively) compared with subjects with the most common haplotype, 111 (frequency 45.5%).

Conclusions/interpretation

Association of the PIK3R1 SNP rs1550805 with serum leptin and body fat may reflect a diminished ability of PI3K to signal via IRS1 or IRS2 in response to leptin.
Appendix
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Literature
1.
go back to reference Schwartz MW, Woods SC, Porte D, Seeley RJ, Baskin DG (2000) Central nervous system control of food intake. Nature 404:661–671PubMed Schwartz MW, Woods SC, Porte D, Seeley RJ, Baskin DG (2000) Central nervous system control of food intake. Nature 404:661–671PubMed
2.
go back to reference Niswender KD, Morrison CD, Clegg DJ et al (2003) Insulin activation of phosphatidylinositol 3-kinase in the hypothalamic arcuate nucleus: a key mediator of insulin-induced anorexia. Diabetes 52:227–231PubMed Niswender KD, Morrison CD, Clegg DJ et al (2003) Insulin activation of phosphatidylinositol 3-kinase in the hypothalamic arcuate nucleus: a key mediator of insulin-induced anorexia. Diabetes 52:227–231PubMed
3.
go back to reference Niswender KD, Morton GJ, Stearns WH, Rhodes CJ, Myers MG, Schwartz MW (2001) Intracellular signalling. Key enzyme in leptin-induced anorexia. Nature 413:794–795PubMedCrossRef Niswender KD, Morton GJ, Stearns WH, Rhodes CJ, Myers MG, Schwartz MW (2001) Intracellular signalling. Key enzyme in leptin-induced anorexia. Nature 413:794–795PubMedCrossRef
4.
go back to reference Kim YB, Uotani S, Pierroz DD, Flier JS, Kahn BB (2000) In vivo administration of leptin activates signal transduction directly in insulin-sensitive tissues: overlapping but distinct pathways from insulin. Endocrinology 141:2328–2339PubMedCrossRef Kim YB, Uotani S, Pierroz DD, Flier JS, Kahn BB (2000) In vivo administration of leptin activates signal transduction directly in insulin-sensitive tissues: overlapping but distinct pathways from insulin. Endocrinology 141:2328–2339PubMedCrossRef
5.
go back to reference Carvalheira JB, Ribeiro EB, Folli F, Velloso LA, Saad MJ (2003) Interaction between leptin and insulin signaling pathways differentially affects JAK-STAT and PI 3-kinase-mediated signaling in rat liver. Biol Chem 384:151–159PubMedCrossRef Carvalheira JB, Ribeiro EB, Folli F, Velloso LA, Saad MJ (2003) Interaction between leptin and insulin signaling pathways differentially affects JAK-STAT and PI 3-kinase-mediated signaling in rat liver. Biol Chem 384:151–159PubMedCrossRef
6.
go back to reference Benomar Y, Roy AF, Aubourg A, Djiane J, Taouis M (2005) Cross down-regulation of leptin and insulin receptor expression and signalling in a human neuronal cell line. Biochem J 388:929–939PubMedCrossRef Benomar Y, Roy AF, Aubourg A, Djiane J, Taouis M (2005) Cross down-regulation of leptin and insulin receptor expression and signalling in a human neuronal cell line. Biochem J 388:929–939PubMedCrossRef
7.
go back to reference Considine RV, Sinha MK, Heiman ML et al (1996) Serum immunoreactive-leptin concentrations in normal weight and obese humans. N Engl J Med 334:292–295PubMedCrossRef Considine RV, Sinha MK, Heiman ML et al (1996) Serum immunoreactive-leptin concentrations in normal weight and obese humans. N Engl J Med 334:292–295PubMedCrossRef
8.
go back to reference Zhao AZ, Huan JN, Gupta S, Pal R, Sahu A (2002) A phosphatidylinositol 3-kinase phosphodiesterase 3B-cyclic AMP pathway in hypothalamic action of leptin on feeding. Nat Neurosci 5:727–728PubMed Zhao AZ, Huan JN, Gupta S, Pal R, Sahu A (2002) A phosphatidylinositol 3-kinase phosphodiesterase 3B-cyclic AMP pathway in hypothalamic action of leptin on feeding. Nat Neurosci 5:727–728PubMed
9.
go back to reference Huang W, Dedousis N, Bhatt BA, O’Doherty RM (2004) Impaired activation of phosphatidylinositol 3-kinase by leptin is a novel mechanism of hepatic leptin resistance in diet-induced obesity. J Biol Chem 279:21695–21700PubMedCrossRef Huang W, Dedousis N, Bhatt BA, O’Doherty RM (2004) Impaired activation of phosphatidylinositol 3-kinase by leptin is a novel mechanism of hepatic leptin resistance in diet-induced obesity. J Biol Chem 279:21695–21700PubMedCrossRef
10.
go back to reference Holman GD, Kasuga M (1997) From receptor to transporter: insulin signalling to glucose transport. Diabetologia 40:991–1003PubMedCrossRef Holman GD, Kasuga M (1997) From receptor to transporter: insulin signalling to glucose transport. Diabetologia 40:991–1003PubMedCrossRef
11.
go back to reference Fruman DA, Cantley LC, Carpenter CL (1996) Structural organization and alternative splicing of the murine phosphoinositide 3-kinase p85 alpha gene. Genomics 37:113–121PubMedCrossRef Fruman DA, Cantley LC, Carpenter CL (1996) Structural organization and alternative splicing of the murine phosphoinositide 3-kinase p85 alpha gene. Genomics 37:113–121PubMedCrossRef
12.
go back to reference Ueki K, Algenstaedt P, Mauvais-Jarvis F, Kahn CR (2000) Positive and negative regulation of phosphoinositide 3-kinase-dependent signaling pathways by three different gene products of the p85alpha regulatory subunit. Mol Cell Biol 20:8035–8046PubMedCrossRef Ueki K, Algenstaedt P, Mauvais-Jarvis F, Kahn CR (2000) Positive and negative regulation of phosphoinositide 3-kinase-dependent signaling pathways by three different gene products of the p85alpha regulatory subunit. Mol Cell Biol 20:8035–8046PubMedCrossRef
13.
go back to reference Terauchi Y, Tsuji Y, Satoh S et al (1999) Increased insulin sensitivity and hypoglycaemia in mice lacking the p85 alpha subunit of phosphoinositide 3-kinase. Nat Genet 21:230–235PubMedCrossRef Terauchi Y, Tsuji Y, Satoh S et al (1999) Increased insulin sensitivity and hypoglycaemia in mice lacking the p85 alpha subunit of phosphoinositide 3-kinase. Nat Genet 21:230–235PubMedCrossRef
14.
go back to reference Shepherd PR, Withers DJ, Siddle K (1998) Phosphoinositide 3-kinase: the key switch mechanism in insulin signalling. Biochem J 333:471–490PubMed Shepherd PR, Withers DJ, Siddle K (1998) Phosphoinositide 3-kinase: the key switch mechanism in insulin signalling. Biochem J 333:471–490PubMed
15.
go back to reference Inukai K, Funaki M, Ogihara T et al (1997) p85alpha gene generates three isoforms of regulatory subunit for phosphatidylinositol 3-kinase (PI 3-kinase), p50alpha, p55alpha, and p85alpha, with different PI 3-kinase activity elevating responses to insulin. J Biol Chem 272:7873–7882PubMedCrossRef Inukai K, Funaki M, Ogihara T et al (1997) p85alpha gene generates three isoforms of regulatory subunit for phosphatidylinositol 3-kinase (PI 3-kinase), p50alpha, p55alpha, and p85alpha, with different PI 3-kinase activity elevating responses to insulin. J Biol Chem 272:7873–7882PubMedCrossRef
16.
go back to reference Hansen T, Andersen CB, Echwald SM, Urhammer SA, Clausen JO, Vestergaard H et al (1997) Identification of a common amino acid polymorphism in the p85alpha regulatory subunit of phosphatidylinositol 3-kinase: effects on glucose disappearance constant, glucose effectiveness, and the insulin sensitivity index. Diabetes 46:494–501PubMed Hansen T, Andersen CB, Echwald SM, Urhammer SA, Clausen JO, Vestergaard H et al (1997) Identification of a common amino acid polymorphism in the p85alpha regulatory subunit of phosphatidylinositol 3-kinase: effects on glucose disappearance constant, glucose effectiveness, and the insulin sensitivity index. Diabetes 46:494–501PubMed
17.
go back to reference Baynes K, Beeton CA, Panayotou G et al (2000) Natural variants of human p85 alpha phosphoinositide 3-kinase in severe insulin resistance: a novel variant with impaired insulin-stimulated lipid kinase activity. Diabetologia 43:321–331PubMedCrossRef Baynes K, Beeton CA, Panayotou G et al (2000) Natural variants of human p85 alpha phosphoinositide 3-kinase in severe insulin resistance: a novel variant with impaired insulin-stimulated lipid kinase activity. Diabetologia 43:321–331PubMedCrossRef
18.
go back to reference Hansen L, Zethelius B, Berglund L et al (2001) In vitro and in vivo studies of a naturally occurring variant of the human p85alpha regulatory subunit of the phosphoinositide 3-kinase: inhibition of protein kinase B and relationships with type 2 diabetes, insulin secretion, glucose disappearance constant, and insulin sensitivity. Diabetes 50:690–693PubMed Hansen L, Zethelius B, Berglund L et al (2001) In vitro and in vivo studies of a naturally occurring variant of the human p85alpha regulatory subunit of the phosphoinositide 3-kinase: inhibition of protein kinase B and relationships with type 2 diabetes, insulin secretion, glucose disappearance constant, and insulin sensitivity. Diabetes 50:690–693PubMed
19.
go back to reference Barroso I, Luan J, Middelberg RP et al (2003) Candidate gene association study in type 2 diabetes indicates a role for genes involved in beta-cell function as well as insulin action. PLoS Biol 1:E20PubMedCrossRef Barroso I, Luan J, Middelberg RP et al (2003) Candidate gene association study in type 2 diabetes indicates a role for genes involved in beta-cell function as well as insulin action. PLoS Biol 1:E20PubMedCrossRef
20.
go back to reference Neale BM, Sham PC (2004) The future of association studies: gene-based analysis and replication. Am J Hum Genet 75:353–362PubMedCrossRef Neale BM, Sham PC (2004) The future of association studies: gene-based analysis and replication. Am J Hum Genet 75:353–362PubMedCrossRef
21.
go back to reference Chapman JM, Cooper JD, Todd JA, Clayton DG (2003) Detecting disease associations due to linkage disequilibrium using haplotype tags: a class of tests and the determinants of statistical power. Hum Hered 56:18–31PubMedCrossRef Chapman JM, Cooper JD, Todd JA, Clayton DG (2003) Detecting disease associations due to linkage disequilibrium using haplotype tags: a class of tests and the determinants of statistical power. Hum Hered 56:18–31PubMedCrossRef
22.
go back to reference Stram DO, Haiman CA, Hirschhorn JN et al (2003) Choosing haplotype-tagging SNPS based on unphased genotype data using a preliminary sample of unrelated subjects with an example from the Multiethnic Cohort Study. Hum Hered 55:27–36PubMedCrossRef Stram DO, Haiman CA, Hirschhorn JN et al (2003) Choosing haplotype-tagging SNPS based on unphased genotype data using a preliminary sample of unrelated subjects with an example from the Multiethnic Cohort Study. Hum Hered 55:27–36PubMedCrossRef
23.
24.
go back to reference Andrew T, Hart D, Snieder H, de Lange M, Spector TD, MacGregor AJ (2001) Are twins and singletons comparable? A study of disease-related and lifestyle characteristics in adult women. Twin Res 4:464–477PubMedCrossRef Andrew T, Hart D, Snieder H, de Lange M, Spector TD, MacGregor AJ (2001) Are twins and singletons comparable? A study of disease-related and lifestyle characteristics in adult women. Twin Res 4:464–477PubMedCrossRef
25.
go back to reference Thompson D, Stram D, Goldgar D, Witte JS (2003) Haplotype tagging single nucleotide polymorphisms and association studies. Hum Hered 56:48–55PubMedCrossRef Thompson D, Stram D, Goldgar D, Witte JS (2003) Haplotype tagging single nucleotide polymorphisms and association studies. Hum Hered 56:48–55PubMedCrossRef
26.
go back to reference Abecasis GR, Cookson WO (2000) GOLD—graphical overview of linkage disequilibrium. Bioinformatics 16:182–183PubMedCrossRef Abecasis GR, Cookson WO (2000) GOLD—graphical overview of linkage disequilibrium. Bioinformatics 16:182–183PubMedCrossRef
27.
go back to reference Trégouët D-A, Ducimetère P, Tiret L (1997) Testing association between candidate-gene markers and phenotype in related individuals, by use of estimating equations. Am J Hum Genet 61:189–199PubMed Trégouët D-A, Ducimetère P, Tiret L (1997) Testing association between candidate-gene markers and phenotype in related individuals, by use of estimating equations. Am J Hum Genet 61:189–199PubMed
28.
go back to reference Dong Y, Zhu H, Wang X et al (2004) Obesity reveals an association between blood pressure and the G-protein beta3-subunit gene: a study of female dizygotic twins. Pharmacogenetics 14:419–427PubMedCrossRef Dong Y, Zhu H, Wang X et al (2004) Obesity reveals an association between blood pressure and the G-protein beta3-subunit gene: a study of female dizygotic twins. Pharmacogenetics 14:419–427PubMedCrossRef
29.
go back to reference Zaykin DV, Westfall PH, Young SS, Karnoub MA, Wagner MJ, Ehm MG (2002) Testing association of statistically inferred haplotypes with discrete and continuous traits in samples of unrelated individuals. Hum Hered 53:79–91PubMedCrossRef Zaykin DV, Westfall PH, Young SS, Karnoub MA, Wagner MJ, Ehm MG (2002) Testing association of statistically inferred haplotypes with discrete and continuous traits in samples of unrelated individuals. Hum Hered 53:79–91PubMedCrossRef
30.
go back to reference Stephens M, Donnelly P (2003) A comparison of bayesian methods for haplotype reconstruction from population genotype data. Am J Hum Genet 73:1162–1169PubMedCrossRef Stephens M, Donnelly P (2003) A comparison of bayesian methods for haplotype reconstruction from population genotype data. Am J Hum Genet 73:1162–1169PubMedCrossRef
31.
go back to reference Avignon A, Boegner C, Mariano-Goulart D, Colette C, Monnier L (1999) Assessment of insulin sensitivity from plasma insulin and glucose in the fasting or post oral glucose-load state. Int J Obes Relat Metab Disord 23:512–517PubMedCrossRef Avignon A, Boegner C, Mariano-Goulart D, Colette C, Monnier L (1999) Assessment of insulin sensitivity from plasma insulin and glucose in the fasting or post oral glucose-load state. Int J Obes Relat Metab Disord 23:512–517PubMedCrossRef
32.
go back to reference Hanley AJ, Williams K, Gonzalez C et al (2003) Prediction of type 2 diabetes using simple measures of insulin resistance: combined results from the San Antonio Heart Study, the Mexico City Diabetes Study, and the Insulin Resistance Atherosclerosis Study. Diabetes 52:463–469PubMed Hanley AJ, Williams K, Gonzalez C et al (2003) Prediction of type 2 diabetes using simple measures of insulin resistance: combined results from the San Antonio Heart Study, the Mexico City Diabetes Study, and the Insulin Resistance Atherosclerosis Study. Diabetes 52:463–469PubMed
33.
go back to reference Purcell S, Cherny SS, Sham PC (2003) Genetic Power Calculator: design of linkage and association genetic mapping studies of complex traits. Bioinformatics 19:149–150PubMedCrossRef Purcell S, Cherny SS, Sham PC (2003) Genetic Power Calculator: design of linkage and association genetic mapping studies of complex traits. Bioinformatics 19:149–150PubMedCrossRef
34.
go back to reference Lake SL, Lyon H, Tantisira K et al (2003) Estimation and tests of haplotype–environment interaction when linkage phase is ambiguous. Hum Hered 55:56–65PubMedCrossRef Lake SL, Lyon H, Tantisira K et al (2003) Estimation and tests of haplotype–environment interaction when linkage phase is ambiguous. Hum Hered 55:56–65PubMedCrossRef
35.
go back to reference Baier LJ, Wiedrich C, Hanson RL, Bogardus C (1998) Variant in the regulatory subunit of phosphatidylinositol 3-kinase (p85alpha): preliminary evidence indicates a potential role of this variant in the acute insulin response and type 2 diabetes in Pima women. Diabetes 47:973–975PubMed Baier LJ, Wiedrich C, Hanson RL, Bogardus C (1998) Variant in the regulatory subunit of phosphatidylinositol 3-kinase (p85alpha): preliminary evidence indicates a potential role of this variant in the acute insulin response and type 2 diabetes in Pima women. Diabetes 47:973–975PubMed
36.
go back to reference Almind K, Delahaye L, Hansen T, Van Obberghen E, Pedersen O, Kahn CR (2002) Characterization of the Met326Ile variant of phosphatidylinositol 3-kinase p85alpha. Proc Natl Acad Sci USA 99:2124–2148PubMedCrossRef Almind K, Delahaye L, Hansen T, Van Obberghen E, Pedersen O, Kahn CR (2002) Characterization of the Met326Ile variant of phosphatidylinositol 3-kinase p85alpha. Proc Natl Acad Sci USA 99:2124–2148PubMedCrossRef
37.
go back to reference Shepherd PR (2005) Mechanisms regulating phosphoinositide 3-kinase signalling in insulin-sensitive tissues. Acta Physiol Scand 183:3–12PubMedCrossRef Shepherd PR (2005) Mechanisms regulating phosphoinositide 3-kinase signalling in insulin-sensitive tissues. Acta Physiol Scand 183:3–12PubMedCrossRef
38.
go back to reference Niswender KD, Schwartz MW (2003) Insulin and leptin revisited: adiposity signals with overlapping physiological and intracellular signaling capabilities. Front Neuroendocrinol 24:1–10PubMedCrossRef Niswender KD, Schwartz MW (2003) Insulin and leptin revisited: adiposity signals with overlapping physiological and intracellular signaling capabilities. Front Neuroendocrinol 24:1–10PubMedCrossRef
39.
go back to reference Kubota N, Terauchi Y, Tobe K et al (2004) Insulin receptor substrate 2 plays a crucial role in beta cells and the hypothalamus. J Clin Invest 114:917–927PubMedCrossRef Kubota N, Terauchi Y, Tobe K et al (2004) Insulin receptor substrate 2 plays a crucial role in beta cells and the hypothalamus. J Clin Invest 114:917–927PubMedCrossRef
40.
go back to reference Yaspelkis BB 3rd, Davis JR, Saberi M et al (2001) Leptin administration improves skeletal muscle insulin responsiveness in diet-induced insulin-resistant rats. Am J Physiol Endocrinol Metab 280:E130–E142PubMed Yaspelkis BB 3rd, Davis JR, Saberi M et al (2001) Leptin administration improves skeletal muscle insulin responsiveness in diet-induced insulin-resistant rats. Am J Physiol Endocrinol Metab 280:E130–E142PubMed
41.
go back to reference Kellerer M, Koch M, Metzinger E, Mushack J, Capp E, Haring, HU (1997) Leptin activates PI-3 kinase in C2C12 myotubes via janus kinase-2 (JAK-2) and insulin receptor substrate-2 (IRS-2) dependent pathways. Diabetologia 40:1358–1362PubMedCrossRef Kellerer M, Koch M, Metzinger E, Mushack J, Capp E, Haring, HU (1997) Leptin activates PI-3 kinase in C2C12 myotubes via janus kinase-2 (JAK-2) and insulin receptor substrate-2 (IRS-2) dependent pathways. Diabetologia 40:1358–1362PubMedCrossRef
42.
go back to reference Chen D, Mauvais-Jarvis F, Bluher M et al (2004) p50alpha/p55alpha phosphoinositide 3-kinase knockout mice exhibit enhanced insulin sensitivity. Mol Cell Biol 24:320–329PubMedCrossRef Chen D, Mauvais-Jarvis F, Bluher M et al (2004) p50alpha/p55alpha phosphoinositide 3-kinase knockout mice exhibit enhanced insulin sensitivity. Mol Cell Biol 24:320–329PubMedCrossRef
43.
go back to reference Kerouz, NJ, Horsch D, Pons S, Kahn CR (1997) Differential regulation of insulin receptor substrates-1 and -2 (IRS-1 and IRS-2) and phosphatidylinositol 3-kinase isoforms in liver and muscle of the obese diabetic (ob/ob) mouse. J Clin Invest 100:3164–3172PubMedCrossRef Kerouz, NJ, Horsch D, Pons S, Kahn CR (1997) Differential regulation of insulin receptor substrates-1 and -2 (IRS-1 and IRS-2) and phosphatidylinositol 3-kinase isoforms in liver and muscle of the obese diabetic (ob/ob) mouse. J Clin Invest 100:3164–3172PubMedCrossRef
Metadata
Title
Phosphatidylinositol 3-kinase p85α regulatory subunit gene PIK3R1 haplotype is associated with body fat and serum leptin in a female twin population
Authors
Y. Jamshidi
H. Snieder
X. Wang
M. J. Pavitt
T. D. Spector
N. D. Carter
S. D. O’Dell
Publication date
01-11-2006
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 11/2006
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-006-0388-z

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