Lifestyle Changes of Type 2 Diabetes Subjects Expressing CDKN2A in Some Tribes in Nigeria

Abstract

Background: Type 2 diabetes (T2D) is characterised by pancreatic beta-cell dysfunction and insulin resistance resulting from the interaction of genetic and environmental factors. The cyclin-dependent kinase inhibitor 2A (CDKN/2A) gene locus has been implicated in T2D susceptibility through genome-wide association studies (GWHAS). However, the molecular mechanisms underlying this association remain elusive. The CDKN2A gene locus is associated with an increased risk of developing T2D. Variants in the CDKN2A gene have been linked to impaired insulin secretion and an increased risk of T2D. Aim: The study aims to evaluate lifestyle changes among type 2 diabetes subjects expressing the CDKN2A gene in some tribes in Nigeria. Methods: This is a cross-sectional study involving 120 female and male participants from the Ijaw, Ogoni, Ikwerre, and Igbo tribes, aged 34-84, attending diabetic clinics at two tertiary hospitals. The Transcript Variants of the CDKN2A gene and biochemical: fasting blood sugar HBA1C, c-peptide, insulin, cystatin C, leptin and homa IR in type 2 markers in type 2 diabetics mellitus subjects from selected ethnic groups. Well-structured questionnaires were randomly administered to the 120 subjects. The gene transcript variants of CDKN2A present in T2DM were assessed and quantified with PCR. Biochemical prognostic markers were determined: Fasting Blood Glucose, HbA1C, Insulin, C-peptide, Leptin, Cystatin C, and HOMA-IR for T2D using immunoassays. The data were analysed using GraphPad Prism (version 8.0.2), with ANOVA, Chi-Square Tests, and Pearson’s correlation; P-values less than 0.005 were considered statistically significant. Results: The results revealed significant associations (p < 0.05) between all examined lifestyle factors and T2D among individuals carrying the CDKN2A gene. The study indicates that HOMA-IR levels are elevated in T2D (P=0.044) following a special diet, suggesting potential difficulties in glycaemic control despite dietary changes. Furthermore, in patients with Type 2 diabetes not on a special diet, CDKN2A CT values are significantly higher (p=0.019), possibly indicating a role for dietary interventions in gene expression. Additionally, BMI levels were higher in smokers compared to non-smokers among type 2 diabetic subjects, highlighting a potential impact of smoking on metabolic health (p=0.042). A significant association was observed between HbA1c and Leptin (p=0.003), whilst CDKN2A levels were associated with insulin and FBS (p=0.003). Other variables demonstrated that TRNA is significantly associated with C-peptide (p=0.001). Significant correlations were noted between HbA1c, FBS, insulin, and HDL-1R in CDKN2A gene carriers with T2D who engaged in regular exercise. A notable association was also identified among those not on a special diet. Regular exercise has been shown to improve glycaemic control and reduce HbA1c levels in type 2 diabetes (T2D). Based on this research, age does not appear to play a significant role in glycaemic control and insulin resistance as long as proper interventions such as appropriate medication, regular exercise, and abstinence from smoking and alcohol are employed. The study further indicates that a special diet does not influence Type 2 diabetic subjects who do not adhere to other lifestyle modifications. Additionally, it notes that exercise reduces the risk of early expression of the CDKN2A gene, which predisposes to Type 2 Diabetes, by a factor of 3 compared with non-exercisers. Conclusion: This knowledge can inform the development of novel biomarkers for early detection and monitoring of T2D. Furthermore, targeting specific genes and pathways involved in T2D pathogenesis may lead to more effective therapeutic strategies.