Premium
Recessive mutations in the cancer gene Ataxia Telangiectasia Mutated ( ATM ), at a locus previously associated with metformin response, cause dysglycaemia and insulin resistance
Author(s) -
Connelly P. J.,
Smith N.,
Chadwick R.,
Exley A. R.,
Shneerson J. M.,
Pearson E. R.
Publication year - 2016
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13037
Subject(s) - ataxia telangiectasia , medicine , endocrinology , insulin resistance , insulin , diabetes mellitus , type 2 diabetes , metformin , glucose tolerance test , carbohydrate metabolism , impaired glucose tolerance , glucose homeostasis , biology , genetics , dna damage , dna
Aim To investigate glucose and insulin metabolism in participants with ataxia telangiectasia in the absence of a diagnosis of diabetes. Methods A standard oral glucose tolerance test was performed in participants with ataxia telangiectasia ( n = 10) and in a control cohort ( n = 10). Serial glucose and insulin measurements were taken to permit cohort comparisons of glucose‐insulin homeostasis and indices of insulin secretion and sensitivity. Results During the oral glucose tolerance test, the 2‐h glucose (6.75 vs 4.93 mmol/l; P = 0.029), insulin concentrations (285.6 vs 148.5 pmol/l; P = 0.043), incremental area under the curve for glucose (314 vs 161 mmol/l/min; P = 0.036) and incremental area under the curve for insulin (37,720 vs 18,080 pmol/l/min; P = 0.03) were higher in participants with ataxia telangiectasia than in the controls. There were no significant differences between groups in fasting glucose, insulin concentrations or insulinogenic index measurement (0.94 vs 0.95; P = 0.95). The Matsuda index, reflecting whole‐body insulin sensitivity, was lower in participants with ataxia telangiectasia (5.96 vs 11.03; P = 0.019) than in control subjects. Conclusions Mutations in Ataxia Telangiectasia Mutated ( ATM ) that cause ataxia telangiectasia are associated with elevated glycaemia and low insulin sensitivity in participants without diabetes. This indicates a role of ATM in glucose and insulin metabolic pathways.