
INTERLEUKIN-18 PROMOTER GENE POLYMORPHISMS
ARE NOT ASSOCIATED WITH MYOCARDIAL INFARCTION
IN TYPE 2 DIABETES IN SLOVENIA Kariž S1*, Petrovič D2 *Corresponding Author: Stojan Kariž, Department of Internal Medicine, General Hospital Izola, Polje
35, Izola 6310, Slovenia; Tel.: +386-5-660-6480; Fax: +386-660-6305; E-mail: stojan.kariz@siol.net page: 3
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PATIENTS AND METHODS
This cross-sectional analysis examined 495 subjects
(263 males, 232 females; age range 46-78 years)
with type 2 diabetes of more than 10 years duration:
169 subjects with MI (MI group) and 326 with no
history of CAD, no signs of ischemic changes on the
electrocardiogram and no ischemic changes during
sub-maximal stress testing (control group). Subjects
were classified as having type 2 diabetes according to
the current criteria of the American Diabetes Association
(ADA) [19]. The diagnosis of MI was made according
to the criteria in [20], patients being studied
1 to 9 months after the acute event. All subjects were
Slovenes of Slavic origin (Caucasians) and came from
independent families. The body mass index (BMI)
was calculated as weight in kilograms divided by the
height in square meters. High sensitivity C-reactive
protein (CRP), glycosylated hemoglobin (Hb A1c), total cholesterol, low density lipoproteins (LDL), high
density lipoproteins (HDL) and triglycerides were determined
by standard biochemical methods. We also
measured serum IL-18 levels in 70 subjects with type
2 diabetes (20 patients with MI and 50 patients without
CAD) and 22 subjects without diabetes. Plasma
IL-18 was determined with enzyme-linked immunosorbent
assay (ELISA) according to the manufacturer’s
instructions (Invitrogen, Carlsbad, CA, USA). The
National Medical Ethics Committee approved the research
protocol. All patients participating in the study
gave written informed consent.
Genomic DNA was isolated from peripheral blood
leukocytes by standard methods and stored at –20°C.
Genotyping was carried out by polymerase chain reaction-
restriction fragment length polymorphism (PCRRFLP)
analysis. The –137 and –607 polymorphisms
in the promoter of the IL-18 gene were determined
as
described in [13].
For the –137 G>C genotyping, a common reverse
primer (5’-AGG AGG GCA AAA TGC ACT GG-3’)
and two sequence-specific forward primers [5’-CCC
CAA CTT TTA CGG AAG AAA AG-3’ (for alelle G)
and 5’-CCC CAA CTT TTA CGG AAG AAA AC-3’
(for alelle C)] were used to amplify a 261 bp product.
A control forward primer was used to amplify a
446 bp fragment that contained the polymorphic site
to serve as an amplification control. The PCR reaction
was performed in a final volume of 5 μL containing
0.5 μL 10 mM dNTP, 1 μL 5 × PCR buffer, 0.2 μL
25 mM MgCl2, 0.15 μL 10 μM of each primer, 0.5 μL
genomic DNA, 2.55 μL H2O and 0.1 μL (0.5 U) GoTaq
DNA polymerase. Two PCR reactions were performed
for each individual DNA sample (for both sequencespecific
forward primers). The cycling conditions were:
denaturation for 2 min. at 94°C, then five cycles each
lasting 20 seconds at 94°C, 60 seconds at 68°C and 60
seconds at 68°C, respectively, followed by 25 cycles of
20 seconds at 94°C, 20 seconds at 62°C, 40 seconds at
72°C and a final elongation for 7 min. at 72°C. Polymerase
chain reaction products were visualized by 2.0%
agarose gel electrophoresis stained by »SYBR Green I«
(Invitrogene, Carlbad, CA, USA).
For the –607 C>A polymorphism, a common
reverse primer (5’-TAA CCT CAT TCA GGA CTT
CC-3’) and two sequence-specific forward primers
[5’-GTT GCA GAA AGT GTA AAA ATT ATT AC-3’
(for alelle C) and 5’-GTT GCA GAA AGT GTA AAA
ATT ATT AA-3’ (for alelle A)] were used to amplify a 196 bp product. A control forward primer (5’-CTT
TGC TAT CAT TCC AGG AA-3’) was used to amplify
a 301 bp fragment covering the polymorphic site
as an internal positive amplification control. The PCR
reaction was performed in a final volume of 5 μL consisting
of 0.5 μL 10 mM dNTP, 1 μL 5 × PCR buffer,
0.2 μL 25 mM MgCl2, 0.15 μl 10 μM of each primer,
0.5 μl genomic DNA, 2.55 μL H2O and 0.1 μL (0.5 U)
GoTaq DNA polymerase. The cycling conditions were:
denaturation for 2 min. at 94°C, then seven cycles each
lasting 20 seconds at 94 ºC, 40 seconds at 64 ºC and 40
seconds at 72 ºC, respectively, followed by 25 cycles
of 20 seconds at 94 ºC, 40 seconds at 57 ºC, 40 seconds
at 72 ºC and a final elongation for 7 min. at 72 °C. PCR
products were separated by electrophoresis on a 2%
agarose gel and visualized by »SYBR Green I« (Invitrogene).
Two investigators (SK, DP), blinded for the
case or control status of the DNA sample, performed
the assignment of genotype.
The χ2 test was used to compare discrete variables
and to compare genotype distributions. Continuous
clinical data were compared by unpaired Student’s
t-test and presented as mean ± standard deviation (SD).
The Hardy-Weinberg equilibrium was confirmed using
the χ2 test. A p value of <0.05 was considered to be
statistically significant. A statistical analysis was performed
using the SPSS program for Windows 2000
version 17 (SPSS Inc., Chicago, IL, USA).
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