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DNA methylation mediates development of HbA1c-associated complications in type 1 diabetes.

Nature metabolism | 2020

Metabolic memory, the persistent benefits of early glycaemic control on preventing and/or delaying the development of diabetic complications, has been observed in the Diabetes Control and Complications Trial (DCCT) and in the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study, but the underlying mechanisms remain unclear. Here, we show the involvement of epigenetic DNA methylation (DNAme) in metabolic memory by examining its associations with preceding glycaemic history, and with subsequent development of complications over an 18-yr period in the blood DNA of 499 randomly selected DCCT participants with type 1 diabetes who are also followed up in EDIC. We demonstrate the associations between DNAme near the closeout of DCCT and mean HbA1c during DCCT (mean-DCCT HbA1c) at 186 cytosine-guanine dinucleotides (CpGs) (FDR < 15%, including 43 at FDR < 5%), many of which were located in genes related to complications. Exploration studies into biological function reveal that these CpGs are enriched in binding sites for the C/EBP transcription factor, as well as enhancer/transcription regions in blood cells and haematopoietic stem cells, and open chromatin states in myeloid cells. Mediation analyses show that, remarkably, several CpGs in combination explain 68-97% of the association of mean-DCCT HbA1c with the risk of complications during EDIC. In summary, DNAme at key CpGs appears to mediate the association between hyperglycaemia and complications in metabolic memory, through modifying enhancer activity at myeloid and other cells.

Pubmed ID: 32694834 RIS Download

Associated grants

  • Agency: NIDDK NIH HHS, United States
    Id: U01 DK094176
  • Agency: NIDDK NIH HHS, United States
    Id: R01 DK081705
  • Agency: NIDDK NIH HHS, United States
    Id: U01 DK094157
  • Agency: NCI NIH HHS, United States
    Id: P30 CA033572
  • Agency: NIDDK NIH HHS, United States
    Id: DP3 DK106917
  • Agency: NIDDK NIH HHS, United States
    Id: R01 DK065073
  • Agency: NHLBI NIH HHS, United States
    Id: R01 HL106089

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