Carotid Intima Media-thickness and Genes Involved in Lipid Metabolism in Diabetic Patients using Statins – a Pathway Toward Personalized Medicine

Jovana      Nikolajevic Starcevic; Danijel      Petrovic

Abstract

The prognostic importance of large artery structure and function in relation to cardiovascular morbidity and mortality, together with the identification of new genetic risk factors have been two major areas of investigation in recent years. Carotid intima-media thickness (CIMT), as measured by B-mode ultrasound, is a surrogate marker for atherosclerosis and can be used to detect an accelerated disease process as well as subclinical disease. However, the genetic basis for CIMT variation is almost unknown. Cardiovascular genetics has led to numerous clinical studies generally focused on only one candidate gene and were frequently conducted in subjects with cardiovascular diseases and/or taking drugs that could affect CIMT.

Pharmacogenetics is the study of the effect of a medication as it relates to single or defined sets of genes. An important goal of pharmacogenetics in cardiovascular disorders is to integrate the two (drugs plus genes) so that true personalized therapy can be delivered. In this paper, we will discuss the interaction between genes involved in lipid metabolism and statin therapy that affects intermediate phenotype (plasma lipid levels) and CIMT in patients with type 2 diabetes.

Keywords: B-mode ultrasound, carotid atherosclerosis, carotid intima-media thickness, epigenetics, gene polymorphisms, intervention trials, personalized medicine, statins, therapeutic efficacy assessment, type 2 diabetes