A common 5'-UTR variant in MATE2-K is associated with poor response to metformin

Clin Pharmacol Ther. 2011 Nov;90(5):674-84. doi: 10.1038/clpt.2011.165. Epub 2011 Sep 28.

Abstract

Multidrug and toxin extrusion 2 (MATE2-K (SLC47A2)), a polyspecific organic cation exporter, facilitates the renal elimination of the antidiabetes drug metformin. In this study, we characterized genetic variants of MATE2-K, determined their association with metformin response, and elucidated their impact by means of a comparative protein structure model. Four nonsynonymous variants and four variants in the MATE2-K basal promoter region were identified from ethnically diverse populations. Two nonsynonymous variants-c.485C>T and c.1177G>A-were shown to be associated with significantly lower metformin uptake and reduction in protein expression levels. MATE2-K basal promoter haplotypes containing the most common variant, g.-130G>A (>26% allele frequency), were associated with a significant increase in luciferase activities and reduced binding to the transcriptional repressor myeloid zinc finger 1 (MZF-1). Patients with diabetes who were homozygous for g.-130A had a significantly poorer response to metformin treatment, assessed as relative change in glycated hemoglobin (HbA1c) (-0.027 (-0.076, 0.033)), as compared with carriers of the reference allele, g.-130G (-0.15 (-0.17, -0.13)) (P=0.002). Our study showed that MATE2-K plays a role in the antidiabetes response to metformin.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Alleles
  • Animals
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Genetic Variation
  • Glycated Hemoglobin / metabolism
  • HCT116 Cells
  • HEK293 Cells
  • Haplotypes
  • Humans
  • Hypoglycemic Agents / pharmacokinetics*
  • Hypoglycemic Agents / pharmacology
  • LLC-PK1 Cells
  • Luciferases / metabolism
  • Male
  • Metformin / pharmacokinetics*
  • Metformin / pharmacology
  • Middle Aged
  • Organic Cation Transport Proteins / genetics*
  • Polymorphism, Genetic
  • Promoter Regions, Genetic
  • Racial Groups / genetics
  • Retrospective Studies
  • Swine
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Organic Cation Transport Proteins
  • SLC47A2 protein, human
  • Metformin
  • Luciferases