Loss-of-function mutations in SLC30A8 protect against type 2 diabetes.
Jason FlannickGudmar ThorleifssonNicola L BeerSuzanne B R JacobsNiels GrarupNoël P BurttAnubha MahajanChristian FuchsbergerGil AtzmonRafn BenediktssonJohn BlangeroDon W BowdenIvan BrandslundJulia BrosnanFrank BurslemJohn ChambersYoon Shin ChoCramer ChristensenDesirée A DouglasRavindranath DuggiralaZachary DymekYossi FarjounTimothy FennellPierre FontanillasTom ForsénStacey GabrielBenjamin GlaserDaniel F GudbjartssonCraig HanisTorben HansenAstradur B HreidarssonKristian HveemErik IngelssonBo IsomaaStefan JohanssonTorben JørgensenMarit Eika JørgensenSekar KathiresanAugustine KongJaspal KoonerJasmina KravicMarkku LaaksoJong-Young LeeLars LindCecilia M LindgrenAllan LinnebergGisli MassonThomas MeitingerKaren L MohlkeAnders MolvenAndrew P MorrisShobha PotluriRainer RauramaaRasmus Ribel-MadsenAnn-Marie RichardTim RolphVeikko SalomaaAyellet V SegrèHanna SkärstrandValgerdur SteinthorsdottirHeather M StringhamPatrick SulemE Shyong TaiYik Ying TeoTanya TeslovichUnnur ThorsteinsdottirJeff K TrimmerTiinamaija TuomiJaakko TuomilehtoFariba Vaziri-SaniBenjamin F VoightJames G WilsonMichael BoehnkeMark I McCarthyPål R NjølstadOluf Pedersennull nullnull nullLeif GroopDavid R CoxKari StefanssonDavid AltshulerPublished in: Nature genetics (2014)
Loss-of-function mutations protective against human disease provide in vivo validation of therapeutic targets, but none have yet been described for type 2 diabetes (T2D). Through sequencing or genotyping of ~150,000 individuals across 5 ancestry groups, we identified 12 rare protein-truncating variants in SLC30A8, which encodes an islet zinc transporter (ZnT8) and harbors a common variant (p.Trp325Arg) associated with T2D risk and glucose and proinsulin levels. Collectively, carriers of protein-truncating variants had 65% reduced T2D risk (P = 1.7 × 10(-6)), and non-diabetic Icelandic carriers of a frameshift variant (p.Lys34Serfs*50) demonstrated reduced glucose levels (-0.17 s.d., P = 4.6 × 10(-4)). The two most common protein-truncating variants (p.Arg138* and p.Lys34Serfs*50) individually associate with T2D protection and encode unstable ZnT8 proteins. Previous functional study of SLC30A8 suggested that reduced zinc transport increases T2D risk, and phenotypic heterogeneity was observed in mouse Slc30a8 knockouts. In contrast, loss-of-function mutations in humans provide strong evidence that SLC30A8 haploinsufficiency protects against T2D, suggesting ZnT8 inhibition as a therapeutic strategy in T2D prevention.