We conducted a genome-wide linkage scan for genes contributing to retinopathy risk using 794 diabetes case subjects from 393 Mexican-American families from Starr County, Texas, having at least two diabetic siblings. The sample included 567 retinopathy case subjects comprising 282 affected sibling pairs. Retinopathy was classified as none, early nonproliferative, moderate-to-severe nonproliferative, or proliferative. Using 360 polymorphic markers (average spacing 9.4 cM), we conducted nonparametric linkage analysis followed by ordered-subset analysis (OSA) ranking families by average age of diabetes diagnosis. For any retinopathy, the highest LOD scores including all families were on chromosomes 3 (2.41 at 117 cM) and 12 (2.47 at 15.5). OSA logarithm of odds (LOD) scores >2 for any retinopathy occurred on chromosomes 12 (4.47 at 13.2 cM), 15 (3.65 at 100.6), and 20 (2.67 at 54.1). Scores >2 for either moderate-to-severe nonproliferative or proliferative retinopathy occurred on chromosomes 5 (2.53 at 11.2 cM), 6 (2.28 at 30.6), and 19 (2.21 at 100.6). Thus, unconditional linkage analysis revealed suggestive evidence of linkage with retinopathy on two chromosomes, whereas OSA revealed strong evidence of linkage on two chromosomes, and suggestive evidence on four. Candidate genes were identified in most implicated regions. Diabetes 56: 1167-1173, 2007 D iabetic retinopathy, a frequent complication of both type 1 and type 2 diabetes, is the fifth most common cause of legal blindness in the U.S. (1). Some degree of retinopathy occurs in virtually all type 1 and 60% of type 2 diabetic patients affected Ն20 years, although severe proliferative retinopathy is more frequent in type 1 diabetes. The underlying causes of diabetic retinopathy have not yet been elucidated, although tight control of hyperglycemia can retard its development and progression (1-4).Although studies of familial aggregation of diabetic retinopathy suggest that genes may influence either its onset (5,6) or its severity (7,8), most studies of the genetics of diabetic retinopathy have involved candidate genes. Polymorphisms in several genes have been associated with diabetic retinopathy, though few associations have been replicated in multiple populations (9). Exceptions include aldose reductase (10 -17) and the insertion/deletion polymorphism of the angiotensin I-converting enzyme (18,19), although the latter association has been questioned (20).In Pima Indians, a genomic scan revealed evidence of linkage between regions on chromosomes 3 and 9 and the occurrence of retinopathy in 136 affected siblings (103 affected pairs) with type 2 diabetes, with a maximum multipoint logarithm of odds (LOD) score of 1.46 for the region on chromosome 9 (21). We here report the results of a genome-wide linkage scan for the occurrence and severity of retinopathy in Mexican-American families from Starr County, Texas, having at least two siblings affected with type 2 diabetes.
RESEARCH DESIGN AND METHODSMexican-American families from Starr County, Texas, having two or mor...