A genetic explanation for the rising incidence of type 1 diabetes, a polygenic disease

J Autoimmun. 2006 Nov;27(3):174-81. doi: 10.1016/j.jaut.2006.08.004. Epub 2006 Oct 17.

Abstract

We had earlier hypothesized, if parents originated from previously isolated populations that had selected against different critical susceptibility genes for a polygenic disease, their offspring could have a greater risk of that disease than either parent. We therefore studied parents of patients with type 1 diabetes (T1D). We found that parents who transmitted HLA-DR3 to HLA-DR3/DR4 patients had different HLA-A allele frequencies on the non-transmitted HLA haplotype than HLA-DR4-transmitters. HLA-DR3-positive parents also had different insulin (INS) gene allele frequencies than HLA-DR4-positive parents. Parent pairs of patients had greater self-reported ethnicity disparity than parent pairs in control families. Although there was an excess of HLA-DR3/DR4 heterozygotes among type 1 diabetes patients, there were significantly fewer HLA-DR3/DR4 heterozygous parents of patients than expected. These findings are consistent with HLA-DR and INS VNTR alleles marking both disease susceptibility and separate Caucasian parental subpopulations. Our hypothesis thus explains some seemingly disconnected puzzling phenomena, including (1) the rising world-wide incidence of T1D, (2) the excess of HLA-DR3/DR4 heterozygotes among patients, (3) the changing frequency of HLA-DR3/DR4 heterozygotes and of susceptibility alleles in general in patients over the past several decades, and (4) the association of INS alleles with specific HLA-DR alleles in patients with T1D.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / genetics*
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease*
  • HLA-A Antigens / genetics
  • HLA-DR3 Antigen / genetics*
  • HLA-DR4 Antigen / genetics*
  • Heterozygote
  • Humans
  • Incidence
  • Insulin / genetics*
  • Male
  • Minisatellite Repeats / genetics
  • Multifactorial Inheritance*
  • Pedigree

Substances

  • HLA-A Antigens
  • HLA-DR3 Antigen
  • HLA-DR4 Antigen
  • Insulin