Clinical and genetic associations with hypertriglyceridemic waist in a Canadian aboriginal population

Objectives: To determine the prevalence of ‘hypertriglyceridemic waist’ (HTGW) in Oji-Cree, to examine its interaction with hepatic nuclear factor-1 α ( HNF1A ) in association with type 2 diabetes, and to characterize its putative genetic determinants. Method: The presence or absence of HTGW was determined in 522 Oji-Cree subjects (223 males, 299 females), ⩾18 years of age, in whom physical measurements and fasting plasma analyte concentrations were gathered, and a 75-g oral glucose tolerance test was administered, as part of a cross-sectional study. Subjects were genotyped for HNF1A codon 319, angiotensinogen ( AGT ) codons 174 and 235, G-protein β 3-subunit ( GNB3 ) nucleotide 825, fatty acid-binding protein ( FABP2 ) codon 54, nucleotides −455 and −482 of the apolipoprotein (apo) C-III ( APOC3 ) promoter, and a 5-bp insertion/deletion polymorphism within the 3′-untranslated region of protein phosphatase 1 regulatory subunit 3 ( PPP1R3 ). Results: The unadjusted prevalence of HTGW in Oji-Cree adults was 20.5%, with more males affected than females (27.8 vs 15.1%, P =0.0004). Logistic regression analysis, adjusted for age and gender, showed type 2 diabetes was associated with both HNF1A G319S (odds ratio (OR) 4.85, 95% CI 2.45, 9.58) and HTGW (OR 4.96, 95% CI 2.49, 9.88). When the HNF1A mutation and HTGW were present in combination, the OR for type 2 diabetes was markedly increased (OR 43.2, 95% CI 12.4, 150). In women only, both GNB3 825C>T and FABP2 A54T genotypes were significantly associated with HTGW (OR 2.02, 95% CI 1.01, 4.05 and OR 1.95, 95% CI 1.01, 3.74, respectively). Conclusions: HTGW is prevalent in Oji-Cree, especially in men. The ORs for type 2 diabetes were similar (∼5-fold) for subjects with either the presence of HTGW or the private HNF1A G319S mutation. These two independent risk factors acted synergistically to confer an even greater increased risk of type 2 diabetes.